卡维地洛对慢性收缩性心力衰竭患者左室功能及运动耐量的影响

Effect of carvedilol on the left ventricular function and exercise tolerance in patients with chronic congestive heart failure

目的观察卡维地洛对慢性收缩性心力衰竭(CHF)患者左室功能及运动耐量的影响。方法选择100例病因不同的CHF患者,随机分为2组,对照组48例应用洋地黄、利尿剂、血管紧张素转换酶抑制剂等常规治疗,治疗组52例在常规治疗的基础上口服卡维地洛。疗程均为6个月。观察2组治疗前后临床疗效、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、血清B型尿钠肽(BNP)、6 min步行距离等。结果治疗6个月后,治疗组的总有效率显著高于对照组(80.8%vs 58.3%,P<0.05)。LVEDD及BNP较治疗前及对照组显著减少(P<0.05,P<0.01)。LVEF、6 min步行距离较治疗前及对照组均显著增加(P<0.05,P<0.01)。结论卡维地洛可明显改善CHF患者左室功能,提高运动耐量,降低BNP的浓度。

Objective To observe the effect of carvedilol on the left ventricular function and exercise tole rance in patients with chronic congestive heart failure（CHF）.Methods Totally 100 cases with CHF caused by different reasons were randomly divided into two groups,of which control group（48 cases） was administrated digitalis, diuretics,angiotensin converting enzyme inhibitors and other conventional treatment,while treatment group（52 cases） with oral carvedilol treatment on the basis of conventional therapy.After 6 months period,the therapeutic effect, left ventricular end diastolic diameter（LVEDD）,left ventricular ejection fraction（LVEF）,serum B type natriuretic peptide（BNP）,6 min walking distance were observed before and after treatment.Results After 6 months,the total effective rate of the treatment group was significantly higher than than that of the control group（80.8%vs 58.3%, P0.05）.The LVEDD and BNP in treatment group were significantly reduced than pre treatment（P0.01）, and the indexes were significantly reduced compared with those in control group（P0.05）.While,the LVEF,6 min walking distance in treatment group were significantly increased compared with pre treatment（P0.01 ）,and they were increased significantly compared with those in control group（P0.05）.Conclusion Carvedilol could improve left ventricular function in patients with CHF,further,to improve exercise tolerance and reduce the level of BNP.