卡维地洛对慢性心力衰竭心功能的影响

Effect of Carvedilon on heart function in patients with Chronic heart failure

目的 探讨卡维地洛对慢性心力衰竭患者心功能的影响。方法 :将 6 0例慢性心力衰竭患者双盲随机分为两组 ,卡维地洛组 (A组 ) 30例 ,美托洛尔组 (B且 ,对照组 ) 30例。两组病人基础临床特征相似 ,应用彩色超声心动图测量病人治疗前、后 6个月射血分数 (EF)左室短轴缩短分数 (FS)及左心室腔径容积变化 ,并观察患者的 NYHA心动能、血压的变化。结果 治疗 6个月后 ,A组的 EF和 FS比 B组明显增高。 (EF:0 .4 6± 0 .2 3%比 0 .39± 0 .18% ,P<0 .0 1) (FS:2 5 .0± 1.6 4 %比 2 2 .3± 1.36 % ,P<0 .0 1)左室舒张末径 (L VDd)和左室收缩末径 (L VDs)均比治疗前缩短分别为 (L VDd:5 0 .0± 0 .76 m m比 37.0± 0 .34mm) (L VDs:5 3.0± 0 .4 7mm比 4 0 .0± 0 .15 mm) ,P均 <0 .0 1。左室舒张末期容积 (L VEDV)和左室收缩末期容积 (L VESV)均比治疗前缩小分别为 [10 4± 0 .15 ) ml比 (31.15±0 .77) ml和 (119± 0 .19) ml比 (34.17± 0 .6 7) ml,均 P<0 .0 1],治疗 6个月后两组患者的 NYHA心功能分级改善。治疗期间 ,卡维地洛组无心衰恶化 ,美托洛尔组有 2例因心衰恶化住院。结论 卡维地洛与美托洛尔对慢性心力衰竭均有较好的疗效 ,前者更优于后者。

objective The study is to observe the effect of Carvedilon on heart function in patients with CHF.Method 60 patients with CHF were divided randomly into two groups on the average.They were group A(Carvedilol)and group B(Metoprolol).Based on the similar clinical character,the change of the left ejection fraction (EF),the fraction shortening(FS)and the left ventriclar dimension on every patient were measured with echpcardiography after the six months treatment,also including the change of their NYHA heart function and blood pressure.Result After the six months treatment,group A(Carvedilol)was improved more obviously than group B(Metoprolol),such as EF and FS(EF:from 0 46±0 23% to 0 39±0 18%,P<0 01)(FS:from 25 0±1 64% to 22 3±1 36%,P<0 01),LVDd and LVDs (LVDd:from 50 0±0 76mm to 37 0±0 34mm,P<0 01)(LVDs:from 53 0±0 47mm to 40 0±0 15mm,P<0 01).The volume of LVEDV and LVESV were smaller than before treatment [LVEDV:from 104±0 15ml to 31 15±0 77ml,P<0 01;LVESV:from 119±0 19ml to 34 17±0 67ml,P<0 01].Meanwhile the NYHA cardiac function of both groups was improved markerdly after te treatment.There was no heart function worsening found from group A and two patients in group B had to be in hospital because of heart function worsening during this period.Conclusion Both of Carvedilol and Metorolol are effective to the patients with CHF,even Carvedilol is more effective than Metoprolol at some aspects.