卡维地洛治疗慢性心力衰竭38例临床观察

目的探讨卡维地洛治疗慢性心力衰竭（CHF）的临床疗效。方法选择我院2008年1月-2010年1月收治的住院与门诊慢性心力衰竭患者76例，随机分为治疗组和对照组各38例，两组均给予吸氧、解痉、强心、利尿、维持水电解质平衡等常规治疗，治疗组在对照组的基础上给予卡维地洛，卡维地洛起始剂量为2．5mg，bid，1周后增至5mg，bid，以后每2周倍增至目标剂量20mg，bid，随诊。观察比较两组患者临床疗效及治疗前后超声心动图的改变，包括左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）、左室射血分数（LVEF）。结果治疗组总有效率94．74％，对照组的总有效率为78．95％，两组总有效率比较差异有显著性。治疗组与对照组患者的LVESD、LVEDD有所降低，且治疗组降低程度优于对照组；两组LVEF有提高，且治疗组提高明显。结论卡维地洛用于慢性心力衰竭的治疗是有效的，但应严格掌握剂量，同时注意其不良反应。

Carvedilol for Chronic Heart Failure: Clinical Observation of 38 Cases

Objective To investigate the clinical effects of carvedilol in the treatment of chronic heart failure （CHF）. Methods We selected 76 cases of CHF in our hospital from Jan. 2008 to Jan.2010 and divided them randomly into treatment group and control group,with 38 in each. Both groups were given conventional therapy including oxygen,antispasmodic,cardiac,diuretic to maintain water and electrolyte balance,and carvedilol was added to treatment group,with its initial dose of 2.5rag,bid,after 1 week increasing to 5mg, bid,later doubling the dose every 2 weeks to the target dose of 20rag, hid. The clinical observation and comparison were made in the two groups before and after treatment by echocardiograph changes including left ventricular end systolic diameter（LVESD）,left ventricular end-diastolic diameter（LVEDD） and left ventricular ejection fraction（LVEF）. Results The total effective rate of the treatment group was 94.74% and that of the control group was 78.95%,with a significant difference between the two groups. LVESD and LVEDD of the two groups were decreased,with a lower level of the treatment group compared with the control group. LVEF of the two groups was increased,with a significant increase in the treatment group. Conclusion Carvedilol is effective in the treatment of CHF,but its dose should be strictly controlled,with more attention to adverse reactions.