比较比索洛尔与卡维地洛治疗慢性充血性心力衰竭的疗效及安全性

目的:比较比索洛尔与卡维地洛治疗慢性充血性心力衰竭的疗效及安全性。方法:选择已接受常规抗心力衰竭治疗的慢性充血性心力衰竭(心脏彩超仪测定左心室射血分数<40%)患者40例,随机分为2组,分别接受比索洛尔或卡维地洛治疗,渐增至最大剂量后,维持6mo。结果:治疗后,心功能、血压、心率2组均较治疗前明显改善(P<0.01),比索洛尔组左心室射血分数、心率较卡维地洛组改善更明显(P<0.05);卡维地洛组左心室舒张末期容量、左心室收缩末期容量、收缩压及舒张压较比索洛尔组改善更明显(P<0.01)。不良反应发生率比索洛尔组为35%,卡维地洛组为60%,有统计学差异(P<0.01);无因不良反应退出试验者。结论:比索洛尔与卡维地洛均可改善慢性充血性心力衰竭患者的心功能,但不同的β受体阻滞药改善的程度有差异。

A Comparison of Therapeutic Effect and Safety of Bisoprolol and Carvedilol in Treatment of Chronic Congestive Heart Failure

OBJECTIVE:To compare the therapeutic effect and safety of Bisoprolol and Carvedilol in the treatment of chronic congestive heart failure(CHF).METHODS:40 patients with CHF,who had received conventional anti-HF therapy UCG determination of left ventricular ejection fraction(LVEF)<40%,were randomized into two groups to be respectively treated with Bisoprolol and Carvedilol for a maintained period of 6mo after the dosages being gradually expanded to maximum. RESULTS:Both groups showed significant improvement in heart function,blood pressure and heart rate after treatment(P< 0.01),with the Bisoprolol group having more obvious improvement in LVEF and heart rate than the Carvedilol group(P< 0.05),and the Carvedilol group having more obvious improvement in LVEDV,LVESV,SP(systolic pressure)and DP(diastolic pressure) than the Bisoprolol group(P<0.01).The occurrence rate of adverse reaction was 35% for the Bisoprolol group and 60% for the Carvedilol group,indicating a statistical difference(P<0.01).There was no exit of enrollees due to adverse reaction.CONCLUSIONS:Bisoprolol and Carvedilol can both improve the heart function of patients with CHF,but there is a difference in the degree of improvement effected with the two β-adrenergic receptor blockers.