卡维地洛与美托洛尔治疗慢性充血性心力衰竭的作用比较

Comparison of the effect of carvedilol and metoprolol in the treatment of chronic congestive heart failure

目的比较分析卡维地洛与美托洛尔在治疗慢性充血性心力衰竭过程中的安全性以及临床治疗效果。方法选取2012年1月至2013年10月该院收治的慢性充血性心力衰竭患者86例,随机分为两组,各43例。观察组在常规治疗基础上给予卡维地洛治疗,对照组在常规治疗基础上给予美托洛尔治疗,对比分析两组治疗前后的心率、血压、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)以及不良反应,判定两组的临床疗效。结果与治疗前比较,两组患者心率、血压、LVEDD、LVEF以及不良反应在治疗后均得以改善,差异有统计学意义(P<0.05)。观察组患者治疗后的各项指标略优于对照组患者,且LVEF组间比较,差异有统计学意义(P<0.05)。观察组和对照组治疗总有效率分别为93.0%和81.4%,差异有统计学意义(P<0.05)。结论作为β受体阻滞剂,在改善慢性充血性心力衰竭患者心功能方面,卡维地洛优于美托洛尔,其疗效更好且不良反应较少。建议临床上优先选择卡维地洛作为治疗慢性充血性心力衰竭药物。

Objective To compare and analyze the safety and clinical effect of carvedilol and metoprolol in the treatment of chronic congestive heart failure（CCHF）. Methods A total of 86 patients with CCHF in the hospital from January 2012 to Oc-tober 2013 were selected and randomized into observation group and control group ,86 cases in each group. The observation group was added with carvedilol on the basis of conventional therapy ,while the control group acquired metoprolol for treatment based on the conventional therapy. Comparative analysis was conducted on heart rate ,blood pressure,left ventricular ejection fraction （LVEF）,left ventricular end-diastolic diameter（LVEDD）,and adverse reactions before and after treatment in both groups to deter-mine the clinical efficacy of the two groups. Results Compared with before treatment,the heart rate,blood pressure, LVEF, LVEDD and adverse reactions of both groups were improved after treatment with statistically significant difference （P〈0.05）. The indicators after treatment of the observation group were slightly better than that of the control group ,and the difference of LVEF between the groups was statistically significant （P〈0.05）. The total efficiency was 93.0%in the observation group and 81.4%in the control group,with a statistically significant difference（P〈0.05）. Conclusion In improving cardiac function in patients with CCHF, the carvedilol is superior to metoprolol asβ-receptor blockers with better efficacy and fewer adverse reactions ,so it is proposed to give priority to carvedilol in the treatment of CCHF clinically.