卡维地洛治疗慢性心力衰竭的临床观察

目的观察卡维地洛治疗慢性心力衰竭的临床疗效。方法75例确诊为慢性心力衰竭的患者在常规应用洋地黄、利尿剂、血管紧张素转换酶抑制剂等基础上加用卡维地洛。起始量为2.5mg（2次/d）直至目标剂量10mg（2次/d）或最大耐受剂量,定期门诊随访,坚持服药6个月,治疗前和治疗6个月后复查超声心动图,观察左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）、左室射血分数（LVEF）及左室缩短分数（FS）,观察临床疗效。结果卡维地洛治疗6个月后,慢性心力衰竭患者的心功能明显改善,总有效率为93.3%,超声心动图显示左室收缩及舒张末期内径缩小,左室射血分数及左室缩短分数增高。结论长期应用卡维地洛治疗慢性心力衰竭可改善心功能及心肌重构,提高生活质量,改善预后。

Clinical observation of carvedilol treatment chronic heart failure

Objective To observe the clinical effect of the treatment with carvedilol for chronic heart failure. Methods 75 patients with chronic heart failure were treated with carvedilol at the beginning dose of 5.0 mg/d and was titrated to 20 mg/d tolerated or the dose can be just rolerated. At the same time all the patients were given conventional medications （digoxin, diuretics,ACE inhibitors）and The curative effect was observed. Left ventricular end-diastolic dimension（ LVEDD）, left ventricular end-systolic dimension （ LVESD）, left ven- tricular ejection fraction（LVEF） and fractional shortening （FS） were measured with echocardiography. Results After treated for 6 months ,The total effective rate in the treatment group was 93.3%. The cardiac function im- proved markedly such as LVEDD（5.8 ±8.6） vs （6.0±8.9） cm,P〈0.01],LVESD（4.5 ±10.2） vs （4.8±9.8） cm,P〈0.01],LVEF （41.8 ±8.7） vs （34.2 ±6.3）%,P 〈0.01],FS（21.8 ±7.5） vs （ 19.6 ± 5.9 ） % , P 〈 0.01 ]. Conclusion Carvedilol possesses good effects and safety in patients of chronic heart failure. It can obviously improve cardiac function and prognosis.