Tei指数评价卡维地洛治疗慢性心衰效果研究

The effects of Carvedilol in treating chronic heart failure evaluated by Tei index

目的:用Tei指数及其他心功能指标评价卡维地洛治疗慢性心衰的效果。方法:63例慢性心衰患者(NYHAⅡ～Ⅲ级)随机分为2组,一组为常规治疗组,用常规抗心衰的方法治疗;另一组为卡维地洛治疗组,在常规治疗方法的基础上加用卡维地洛。所有的病人至少随访6个月,用超声心动图分别检查左室射血分数(LVEF)、Tei指数、左室舒张末期内径(LVIDd)、室间隔舒张末期厚度(IVSd)、左室后壁舒张末期厚度(LVPWd)以及左室的等容收缩期(ICT)、等容舒张期(IRT)、射血时间(ET)。结果:治疗后常规治疗组和卡维地洛治疗组的LVIDd、ICT、IRT和Tei指数均较治疗前显著减低,IVSd、LVPWd、LVEF和ET均显著增加。治疗6个月后,卡维地洛治疗组的LVEF和ET显著高于常规治疗组(P<0.05,P<0.01),卡维地洛治疗组的Tei指数和ICT显著低于常规治疗组(P<0.01,P<0.05)。结论:在常规治疗方法的基础上加用卡维地洛治疗慢性心衰效果好于仅用常规的方法治疗。Tei指数较LVEF和NYHA分级法评价心功能更为敏感。

Objective： To evaluate the effect of Carvedilol on the cardiac function in patients with chronic heart failure （CHF） using Tel index and other cardiac function index. Methods： Sixty-three cases of CHF（NYHA Ⅱ-Ⅲ） were divided randomly into two groups： one group received regular treatment, while the other group was treated with Carvedilol on the basis of regular treatment. All the patients were followed up for at least six months. Left ventricular ejection fraction（LVEF）, Tel index, left ventricular internal diameter at end-diastole（LVIDd）, interventricular septal thickness at end-diastole （IVSd）, left ventricular posterior wall thickness at end-diastole（LVPWd）, and isovolumic contraction time（ICT）, isovolumic relaxation time （IRT）, ejection time （ET） of left ventricle were measured by echocardiography. Results： Compared with pre-treatment, LVIDd, ICT, IRT and Tel index were significantly decreased and IVSd, LVPWd, LVEF, ET were significantly increased after treatment in both regular treatment group and Carvedilol treatment group. After treatment of six months, LVEF and ET in Carvedilol treatment group were significantly higher than those in regular treatment group （P〈0.05,P〈0.01）, Tei index, and ICT in Carvedilol treatment group were significantly lower than those in regular treatment group （P〈0.01, P〈0.05）. Conclusions： Carvedilol treatment together with regular treatment is more effective than regular treatment only in improving cardiac function of CHF patients and Tei index is more sensitive than LVEF and NYHA classification in evaluating cardiac function.