卡维地洛对扩张型心肌病与缺血性心肌病心力衰竭患者的疗效比较

Comparison on the effects of Carvedilol for the patients with dilated cardiomyopathy and ischemic cardiomyopathy complicated with heart failure

目的评价卡维地洛对扩张型心肌病与缺血性心肌病心力衰竭患者的临床疗效。方法将2013年1月～2015年12月火箭军总医院诊治的扩张型心肌病患者62例和缺血性心肌病患者70例随机分成治疗组和对照组。心力衰竭患者均根据个体化给予利尿剂、硝酸酯类、血管紧张素转换酶抑制剂等药物治疗。治疗组在常规药物治疗的基础上加用卡维地洛，观察卡维地洛对心室重构及心功能的影响。结果经过6个月的治疗，与对照组比较，治疗组左心室射血分数明显升高（P〈0．05），左心室收缩末容量指数、左心室舒张末容量指数、左心室重量指数均显著降低（P〈0．05）。结论卡维地洛能显著改善扩张型心肌病与缺血性心肌病引起的心力衰竭患者的心功能，改善心室重构，且卡维地洛对缺血性心肌病心力衰竭患者的改善情况较扩张型心肌病心力衰竭患者更好。

Objective To evaluate the clinical effects of Carvedilol for the patients with dilated cardiomyopathy and is- chemic cardiomyopathy complicated with heart failure. Methods Sixty-two patients with dilated cardiomyopathy and 70 patients with ischemic cardiomyopathy treated in the General Hospital of PLA Rocket Force from January 2013 to De- cember 2015 were randomly divided into treatment group and control group. The patients with heart failure were all given diuretieum, nitrates, angiotensin converting enzyme inhibitors and other drugs for anti-heart failure according to the individuation, on basis of conventional treatment, the treatment group was treated with Carvedilol. The effects of Carvedilol for ventrieular remodeling and cardiac function were observed. Results After treatment for 6 months, com- pared with control group, the left ventricular ejection fraction in the treatment group was significantly increased （P 〈 0.05）, however, the left ventricular end-systolic volume index, left ventricular end-diastolic volume index and left ven- tricular mass index in treatment group were significantly decreased （P 〈 0.05）. Conclusion Carvedilol can improve the cardiac function and ventricular remodeling of patients with heart failure caused by dilated cardiomyopathy and is- chemic cardiomyopathy effectively. Furthermore, the therapeutic efficiency of Carvedilol for the patients with heart fail- ure caused by ischemic cardiomyopathy is better than that of patients with heart failure caused by dilated cardiomyopathy.