卡维地洛递进式给药物治疗慢性心衰患者心率变异性及近期的疗效

Progressive administration of carvedilol in patients with chronic heart failure:effects on heart rate variability and short-term outcomes

目的:探讨卡维地洛递进式给药物治疗慢性心衰(CHF)患者心率变异性(HRV)及其对患者近期疗效的影响。方法:获取2012年1月-2015年1月期间因CHF入院就诊的患者78例,完全随机分为观察组和对照组,每组39例。给予对照组卡维地洛常规方法给药物治疗,给予观察组卡维地洛递进式给药物治疗,治疗周期为6个月;治疗前后对所有患者进行24 h动态心电图检查心率HRV和心功能各项指标,并比较两组治疗疗效,观察两组治疗后不良反应发生情况。结果:两组治疗前后HRV指标均明显升高,但治疗后观察组HRV SDNN、SDANN、r MSSD、PNN50指标分别为(112.37±8.16)ms、(89.95±7.24)ms、(39.56±5.57)ms、(6.89±0.61)%较对照组显著升高(P<0.05);治疗后,观察组患者心功能LVS、LVD、LVEDV指标分别为(46.41±1.79)mm、(51.46±1.92)mm、(168.26±42.91)m L显著低于对照组(P<0.05),LVEF指标为(57.13±9.06)%显著高于对照组(P<0.05);并且观察组总有效率为89.74%显著高于对照组71.79%(P<0.05);两组不良反应发生率分别为5.19%、7.69%,差异无统计学意义(P>0.05)。结论:卡维地洛递进式给药物对CHF患者HRV和心功能有明显的改善作用,疗效显著,安全性高,较传统或常规方法给药物方式疗效更好,更值得广泛推广。

Objective：To investigate the effects of progressive administration of Carvedilol on heart rate variability （HRV）in patients with chronic heart failure （CHF）and its short-term outcomes. Methods：Included in this study were 78 CHF patients who were admitted in our hospital between January 2012 and January 2015. The patients were randomly divided into the study group and control group （n=39 each）. The control group was medicated with Carvedilol via conventional administration,while the study group with Carvedilol via progressive administration. The treatment lasted for 6 months. Before and after the treatment, all patients underwent monitoring with 24 h Holter ECG for measures of HRV and cardiac functions. The two groups were compared for efficacy of treatment and adverse events after treatment. Results：HRV measures were significantly elevated at baseline in the both groups. After treatment,the HRV measures SDNN,SDANN,rMSSD and PNN50 in the study group were （112.37±8.16）ms,（89.95±7.24）ms,（39.56±5.57）ms and （6.89±0.61）%,which were significantly higher than those in the control group （all P〈0.05）. After treatment,the cardiac function measures LVS,LVD,and LVEDV in the study group were （46.41±1.79）mm,（51.46±1.92）mm and （168.26±42.91） ml,which were significantly lower than those in the control group （P〈0.05）. The cardiac function measure LVEF indicators was （57.13±9.06）%in the study group,which was also significantly higher compared with the control group （P〈0.05）. The overall effective rate was 89.74%in the study group,which was significantly higher than 71.79%in the control group （P〈0.05）. The rate of adverse events was 5.19%in the study group and 7.69%in the control group, with no significant difference between each other （P〉0. 05 ）. Conclusion：Carvedilol via progressive administration is obviously effective and safe in improving HRV and cardiac functions in patients withnbsp;CHF. Progressive administration of Carvedilol seems to result in better outcomes compared with conventional administration,and therefore is worthy of widespread use.