卡维地洛与美托洛尔治疗扩张型心肌病合并心力衰竭的疗效比较

Comparison of the effect of carvedilol and metoprolol in the treatment of dilated cardiomyopathy patientswith heart failure

目的比较卡维地洛与美托洛尔治疗扩张型心肌病（DCM）合并心力衰竭的临床疗效。方法将90例DCM合并心力衰竭患者按照治疗方法不同分为观察组和对照组，各45例。两组均采用利尿、扩血管、强心等药物治疗，对照组加用美托洛尔，观察组加用卡维地洛。连续治疗4-6个月。治疗前后检测和比较两组患者左室射廊分数（LVEF）、左室收缩末内径（LVESVI）、左室舒张内径（LVEDVI）、左心室短轴缩短率（FS）、最大峰值血流速度（hCFV）、冠状动脉啦流储备（GFR）、觑清内皮素（ET）及一氧化氮（N0）含量。结暴观察组治疗后LVEF、LVEDVI、LVESVI、FS、hCFV、CFR、ET、NO分别为（44．0±3．4）ml／m^2、（45．2±6．9）mm、（20．9±5．4）mm、（30.4±5．3）、（78，2±31，6）cm/s、（3.12±0.36）、（52，2±5．6）ng／L、（5．2±0．67）μmol／L，均优于对照组治疗后的（37.9±3.5）ml／m^2、（51，1±7，6）mm、（20，7±6．3）mm、（25．2±7．3）、（70．5±31.8）cm／s、（2．85±0．23）、（63.5±1.8）ng／L、（2，55±0，33）μmol／L（t=8．386、-3．856、-4．487、3．867、-1．152、-4．239、12．887、-23．802，均P〈0.05）。结论 卡维地洛是治疗DCM合并心理衰竭的有效药物，能改善患者心功能、冠脉癣流储备能力及内废功能，效果满意，值得在临床推广。

Objective To compare the clinical officacy of oarwdilol and metoprolol in the treatment of dilat-ed cardiomyopathy patients with heart failure （DCM）, Methods According to the different treatment method, 90 DCM patients with heart failure patients were divided into the observation group and the control group,45 cases in each group. Both groups were given a diuretic, vasodilator, cardiao and other drug treatment, and the control group were added with metoprolol,and the observation group were added with carvodilol. The treatment lasted 4 to 6 months. Before and after treatment, the levels of left ventricular ejection fraction（LVEF） ,left ventricular end-systolic diameter （ LVESVI）, left ventricular diastolic diameter （LVEDVI）, left ventricular fractional shorteningrate （ FS）, largest peak velocity （ hCFV）, coronary flow reserve （ CFR）, simultaneous deteotion of serum levels of endothelin （ET） and nitric oxide（NO） content were observed and compared between the two groups. Results After the treatment, the levels of LVEF, LVESVI, LVEDVI, FS, hCFV, CFR, ET, NO of the observation group were （ 44.0 ±3.4 ） ml/m2, （ 45.2 ± 6.9）mm,（20.9±5.4）mm,（30.4 ±5.3）, （78, 2±31. 6） cm/s, （3, 12 ±0.36）, （52.2 ±5.6）ng/L, （5.2 ± 0.67） ±mol/L,respectively, which were better than those of those control group [ （37.9±3.5 ）ml/m2, （51. 1 ± 7.6）mm,（20.7 ±6.3） mm,（25.2 ±7.3）,（70.5 ±31,8）cm/s, （2.85 ±0.23）,（63.5 ± 1.8）ng/L, （2.55 ± 0. 33）μmol/L] （t = 8. 386, - 3. 856, - 4. 487,3,867,-1. 152, -4. 239,12. 887, - 23. 802, all P 〈 0. 05 ）. Conclusion Carvedilol is an effective drug for the treatment of DCM consolidated psychological failure, which can improve heart function and coronary flow reserve capacity and endothelial function in patients, which is worth in the clinical with satisfactory results.Cardiomyopathy, dilated ; Heart failure, congestive; Carvedilol ; Metoprolol