卡维地洛在扩张型心肌病治疗中适当剂量的临床研究

Clinical study on carvedilol in the treatment for dilated cardiomyopathy with the appropriate dose

目的探讨卡维地洛在扩张型心肌病治疗中的适当剂量与效果。方法35例扩张型心肌病心力衰竭患者以靶心率作为治疗目标，将患者分为治疗组（靶心率55次／min，n=25）和对照组（靶心率60次／rain，疗=10），都采用常规药物配合卡维地洛治疗。结果两组患者观察指标治疗后都有明显改善，其中治疗组的收缩压、左心室射血分数、左心室舒张末期内径、左心室收缩末期内径、6MWT和心胸比率改善程度明显好于对照组（P〈0．05）。两组患者达到药物最大耐受剂量的比例类似，无显著差异沪〈0．05）。结论卡维地洛治疗扩张型心肌病心力衰竭（NYHA心功能分级Ⅱ～Ⅲ级）患者3个月可以获得显著疗效；卡维地洛治疗扩张型心肌病心力衰竭患者，将靶心率设为55次／min左右是安全的，同时建议适当剂量为0．8mg／（kg·d）。

ObJective To investigate the effect of carvedilol in the treatment of dilated cardiomyopathy with the appropriate dose. Methods 35 cases of dilated cardiomyopathy with heart failure were selected and used target heart rate （THR） as a therapeutic target, patients were divided into treatment group （THR 55 beats/min, n=25） and control group （THR 60 beats/min, n=-10）. Conventional drug treatment with carvedilol was used. Results After the observation, the outcome measures after treatment in two groups had significantly improved the treatment group, systolic blood pressure, left ventricular ejection fraction, left ventricular end-diastolic diameter, left ventricular end systolic diameter, 6MWT and cardiothoracic ratio improved significantly better than the control group （P〈0.05）. The two groups achieved a percentage of the drug＇ s maximum tolerated dose was similar to contrast the two groups with no significant difference （P〈0.05）. Conclusion 3 months after the carvedilol treatment in patients with dilated cardiomyopathy heart failure （NYHA func- tional classification gradeⅡ～Ⅲ can obtain significant efficacy; carvedilol used in pdilated cardiomyopathy patients with heart failure, it is safe the THR set at 55 times / min or so, and the appropriate dose of 0.8 mg/（kg· d） is recommended.