卡维地洛与美托洛尔治疗心力衰竭的对比研究

Comparison Study of Carvedilol with Metoprolol in Treating Congestive Heart Failure

目的:探讨目标剂量的倍他乐克(酒石酸美托洛尔)、卡维地洛对心力衰竭(CHF)患者的治疗效果和二者疗效的差异。方法:采用超声心动图评价104例CHF患者的左心室射血分数(LVEF)及缩短分数(FS)和左心室质量指数(LVMI),并同时检测6 min步行距离(MWT6)、收缩压和舒张压。在基础抗CHF治疗后加用卡维地洛或倍他乐克治疗,从小剂量开始,逐步达到患者的最大耐受剂量,治疗6个月后重复检测以上观察指标。结果:两组患者在使用β受体阻滞剂前所有观察指标无显著差异,治疗6个月后两组患者所有观察指标都有显著好转,但卡维地洛组患者MWT6的改善比倍他乐克组患者更明显,其血压的下降更显著。结论:倍他乐克、卡维地洛治疗6个月均能改善CHF患者的左室功能,增加左室射血分数,提高运动耐量。而卡维地洛似乎降血压和改善运动耐量(MWT6)的治疗效果更优。

Objective：To discuss the curative effect and different of target dose of carvedilol and metoprolol in patients with chronic congestive heart failure（CHF）.Methods：The left ventricular ejection fraction（LVEF）、left ventricular shortening fraction（SF）and left ventricular mass index（LVMI） were assessed by Doppler echocardiography;6 minutes walk test and blood pressure were measured in 104 cases with CHF.After the conventional treatment,the carvedilol or metoprolol were given to those patients with CHF.The carvedilol or metoprolo was increased to the highest endurance doses step by step from low doses in the two grops.Then the aforesaid estimates were repeated after 6 months.Results：LVEF、SF、LVMI、MWT6 and SBP、DBP in two groups had no significant different before treating.The aforesaid estimates had changed obviously after 6 months treatment.And the MWT6 in carvedilol group was increased better than in metoprolols,and the blood pressure was decreased in carvedilol group apparently too.Conclusion：After 6 months treatment,beta-blocker（carvedilol or metoprolol） can obviously improve the left ventricular function,and increase LVEF、exercising tolerance in patients with CHF.However,carvedilol is better in increasing exercising tolerance（MWT6） and decreasing blood pressure.