卡维地洛治疗慢性充血性心力衰竭的临床观察

目的:观察卡维地洛治疗慢性充血性心力衰竭的临床效果和毒副作用。方法:各种原因所致慢性充血性心力衰竭患者68例,在常规治疗、病情基本稳定的基础上,随机分为对照组和观察组各34例。对照组予强心甙、利尿药、血管扩张剂和血管紧张素转换酶抑制药治疗,观察组在对照组治疗基础上加用卡维地洛治疗,初始剂量2.5mg,2次/d,每2周剂量倍增1次,直至最大剂量20mg,2次/d。治疗持续3个月以上。结果:卡维地洛组心功能改善的临床显效率47.1%和总有效率91.2%,均高于对照组(26.5%和67.6%),总有效率差别有统计学意义(P<0.05)。与治疗前相比,卡维地洛组心率、血压、左心室射血分数、左心室舒张末期内径均有显著改善,差异有统计学意义,疗效优于对照组。结论:卡维地洛治疗慢性充血性心力衰竭疗效确切,毒副作用轻微,值得在常规治疗基础上推广使用。

The Clinical Observation of Carvedilol in Treatment of Chronic Congestive Heart Failure

Objective： To observe the clinical effect of carvedilol in treatment of chronic congestive heart failure and its toxic and side reaction. Methods： 68 cases of chronic congestive heart failure caused by various factors were randomly and equally divided into two groups. The treatment group was given cardiac glycoside, diuretics, vasodilators and angiotensin-conveting enzyme inhibitors, and the observation group was treated with earvedilol on the basis of the above mentioned drugs. The initial dosage of earvedilol was 2. 5rag, hid, and duration of treatment was over 3 menths. Results： In the observation group the excellent effective rate and the overall effective rate were 47. 1 % and 91. 2 %, respectively, and higher than that in control group（26.5% and 67.6%, respectively）. The statistical difference was significant be- tween the two groups （P〈0. 05） in the overall effective rate. The heart rate, blood pressure, LVEF and LVEDd improved in the observation group compared with that before treatment and the difference was significant statistically. Conclusion：Carvedilol has dramatic effect of treating chronic congestive heart failure, and the toxic and side reaction is mild. So it is worth spreading application in the usual treatment of chronic congestive heart failure.