卡维地洛治疗慢性心力衰竭的临床疗效

目的:旨在观察卡维地洛治疗慢性心力衰竭的临床疗效。方法:54例慢性充血性心力衰竭患者随机分为卡维地洛组34例和常规治疗组20例,常规组应用传统心力衰竭治疗(血管紧张素转换酶抑制剂、利尿剂、洋地黄制剂),卡维地洛组在传统治疗基础上加用卡维地洛,平均最大剂量为(30.7±13.0)mg/d。两组均治疗半年,治疗前后采用超声心动、6分钟步行试验等方法进行疗效观察。结果:治疗后卡维地洛组较常规治疗组心功能明显改善,6分钟步行试验距离明显增加[(419.26±71.98)m/(382.50±53.4)m],左室射血分数明显增加[(50.41±10.91)％,(41.70±7.45)％],左室舒张末经、收缩末经明显缩小[(57.50±7.29)mm/(64.09±7.40)mm、(43.17±8.27)mm/(52.93±8.35)mm],心肌耗氧量明显降低[(7748.38±1984.00)/(9461.00±1413.19)]。结论:常规治疗充血性心力衰竭基础上加用卡维地洛能够显著缩小左心室舒张及收缩末径,显著提高心功能,提高运动耐量,降低心肌耗氧量。

The Clinical Effect of Treatment with Carvedilol in Chronic Heart Failure

Objective:. To evaluate the clinical effect of carvedilol on patients with chronic heart failure(CHF). Methods: 54 patients with CHF were randomly divided into two groups. ACEI+digoxuM-diuretic were given to the 20 patients in the group control (C) .The patients in the group carvedilol (T) were treated with carvedilol+ACEI+digoxin+diuretic. The biggest dosage of carvedilol was (30.7+13.0)mg/d. All the patients were followed up for 1/2 year. LVEDD, LVESD and LVEF were observed by echocardiography .and the exercise endurance were evaluated by 6-minutes walking test before and after the treatment. Results: LVEF of the patiets in the group T were increased significantly[(50.41+10.91)%vs(41.70+7.45),P= 0.003].Compared with the patients in the group C ,the LVEDD and LVESD of the patients in the group T were significantly decreased [(50.70+7.29)mm vs (64.09+7.40)mm, P=0.002;(43.17+8.27)mm vs (52.93+8.3S)mm,P=0.000].The same result was observed in the rayocardial oxygen consumption of the patients in the group T [(7748.38+1984.00)vs (9461.00+1413.19),P= 0.000].The distance of 6-minutes walking test of the patients in the group T were also significantly increased [(419.26+ 71.98)mvs(382.50+53.40)m,B=0.037]. Conclusions: Carvedilol could improve the cardiac function of the patients with CHF with the standard treatment. The exercise endurance of theses patients were increased at the same time.