卡维地洛治疗充血性心力衰竭的疗效及安全性分析

Study of carvedilol on safety and effect in patients with congestive heart failure (CHF)

目的:探讨卡维地洛(carvedilol)治疗心力衰竭患者的疗效及安全性。方法:住院的NYHA Ⅱ～Ⅳ级心衰患者在常规治疗(强心、利尿、扩血管)基础上加用卡维地洛,起始剂量5mg/d,如能耐受则逐渐增加到最大耐受量。通过临床监测及调查表随访观察其疗效及不良事件,并与对照组比较。结果:(1)20例卡维地洛组患者至随访结束时平均卡维地洛用量为29.25±7.46mg/d(10～40mg/d),心功能分级、心肌氧耗指数、SV、LVEDd、6分钟步行距离明显改善(P<0.05),LVEF、LVFS改善非常显著(P<0.01);(2)卡维地洛治疗可以明显增加血清SOD浓度(P<0.05)。降低血清丙二醛浓度(P<0.05);(3)不良反应共47次,主要包括:乏力、头昏、低血压等,无严重不良事件发生,NYHA Ⅳ级患者不良反应较NYHAⅡ～Ⅲ级者多;(4)不良反应主要发生在5mg/d及10mg/d时的初始期(占40.4％)。结论:第3代β阻滞剂卡维地洛对于我国心衰患者疗效好,不良反应少,安全性高。

Objective: The purpose of the study was to evaluate the effect and safety of carvedilol in patients with CHF (NYHA classⅡ - Ⅳ). Methods: A total of 20 patients with CHF were treated with carvedilol at the beginning dose of 5mg/d and then slowly increased to 40mg/d as tolerated or to the dose can be just tolerated. At the same time, adverse events and results were evaluated. Results: After carvedilol therapy, (l)The NYHA class,index of myocardial oxygen consumption, SV, LVEDd, walk testing of 6 minutes ameliorated significantly (P<0. 05), LVEF, LVFS increased very significantly (P<0. 01), the mean dose of carvedilol was 29. 25±7. 46 mg/d; (2) Level of superoxide dismutase (SOD) increased (P<0. 05), malondialdehyde (MDA) decreased (P<0. 05) ; (3) There were 47 adverse events (mainly contain asthenia, dizzy, hypotension) happen at low dose or un-tolerated period, no serious adverse event happen. Conclusion: Carvedilol possesses good effects and safety in patients with CHF.