卡维地洛治疗小儿扩张型心肌病的机制及安全性分析

Mechanisms and Safety Analysis of Carvedilol in the Treatment of Children with Dilated Cardiomyopathy

目的:分析卡维地洛治疗小儿扩张型心肌病(DCM)的机制及安全性,探讨改善DCM患儿心功能的方法。方法:将92例DCM患儿随机分为观察组和对照组各46例,对照组给予美托洛尔治疗,观察组给予卡维地洛治疗,持续治疗6个月,治疗前后测量患儿血清N末端脑利钠肽前体(NT-pro BNP)、超氧化物歧化酶(SOD)、丙二醛(MDA)变化。结果:治疗后观察组NT-pro BNP、MDA浓度低于对照组(P<0.05),左心室射血分数(LVEF)、SOD活性高于对照组(P<0.05)。观察组达药物最大剂量耐受率为88.64%,高于对照组的72.09%(P<0.05)。结论:卡维地洛治疗小儿DCM耐受性良好,无严重不良反应,可逆转患儿心室重塑,其机制可能与降低心肌氧化应激有关。

Objective： To analyze mechanisms and safety of carvedilol in the treatment of children with dilated cardiomyopathy（ DCM）,improve heart function in children. Methods： Ninety-two children were randomly divided into two groups,46 children in each group,the control group received metoprolol for treatment,while the observation group received carvedilol for treatment,lasting6 months. Serum N-terminal brain natriuretic peptide precursor（ NT-pro BNP）,superoxide dismutase（ SOD）,malondialdehyde（ MDA）changes were measured before and after treatment. Results： After treatment,the levels of NT-pro BNP,MDA in the observation group were lower than the control group（ P〈0. 05）,left ventricular ejection fraction（ LVEF） and level of SOD were higher than the control group（ P〈0. 05）. Tolerated the maximum dose of the drug in the observation group was 88. 64%,higher than that in the control group of 72. 09%（ P〈0. 05）. Conclusion： Carvedilol in treatment of children with DCM has well tolerated,with no serious adverse reactions in children,and can reverse ventricular remodeling,which may be associated with decreased myocardial oxidative stress.