卡维地洛对慢性充血性心衰的疗效及安全性研究

Efficacy and Safety of Carvedilol on the Treatment of Chronic Congestive Heart Failure

目的:探讨卡维地洛治疗慢性充血性心衰的临床疗效与安全性。方法:180例慢性充血性心力衰竭患者随机分为研究组和对照组,每组90例。研究组在常规抗心衰治疗基础上给予卡维地洛,从起始剂量逐步增加至目标剂量或最大耐受量。对照组在常规抗心衰治疗基础上,按照研究组卡维地洛的使用方法给予安慰剂。两组均治疗24周。治疗前后观察两组患者的HR、BP、心功能NYHA分级、超声心动图及不良反应等。结果:研究组与对照组总有效率分别为96.67%、82.22%;研究组治疗后HR、SBP降低,运动耐量指标提高,左心室射血分数(LVEF)改善,左室舒张末期内径(LVEDD)及左室收缩末容积(LVESD)减小,NE、PRA、AngⅡ下降,无明显不良反应,与对照组比较,差异有统计学意义(P<0.05)。结论:在常规抗心衰治疗基础上,对Ⅱ、Ⅲ级心力衰竭患者加用卡维地洛治疗,临床疗效确切。

Objectives：To explore the efficacy and safety of treating chronic congestive heart failure（CHF） with carvedilol.Methods：A total of 180 patients with chronic CHF were randomly divided into study group and control group,90 in each.Carvedilol was gradually added to conventional therapy from initial dose to the target or maximum dose tolerated in the study group,while placebo was given in the same pattern as carvedilol in the control group.The course was 24 weeks.The heart rate,blood pressure,echocardiography were measured and heart function was classified with the New York Heart Association（NYHA） classification before and after treatment,as well as adverse effects were recorded.Results：Total efficacy of the study and control groups were 96.67% and 82.22%,respectively.After the treatment,the patients＇ heart rate and systolic blood pressure were decreased,exercise tolerance index was increased,left ventricular ejection fraction was improved,left ventricular diastolic dimension and left ventricular systolic dimension were decreased,and the expression of noradrenalin,plasma renin activity and angiotensin Ⅱ were decreased in the study group,as compared with the control group with a significant difference（P0.05）,and no obvious adverse reactions occurred.Conclusion：Carvedilol based on conventional therapy may be effective to patients with chronic CHF of NYHA grades Ⅱ or Ⅲ,with fewer adverse reactions.