卡维地洛对尿毒症心肌病患者的疗效观察

目的 探讨卡维地洛对尿毒症心肌病的干预作用.方法 104例尿毒症心肌病患者随机分为两组,每组52例.一组予以常规治疗(对照组),另一组在常规治疗基础上应用卡维地洛12.5～50mg/d(治疗组),总疗程6个月.治疗前后用彩色多普勒检测左室相关数据并测定尿素氮(BUN)、血清肌酐(Set)及内生肌酐清除率(Ccr).结果 与治疗前比较,治疗后两组患者每搏心输出量(SV)、每分心输出量(CO)及射血分数(EF)升高,左室舒张末内径(LVEDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室重量(LVM)及左室重量指数(LVMI)下降(P＜0.01),且治疗组疗效明显优于对照组(P＜0.05),Ccr有增加趋势,BUN、Scr有下降趋势,但差异均无统计学意义(P＞0.05).结论 卡维地洛能有效抑制尿毒症心肌病患者的心室重塑,改善心功能及心脏结构,但对肾功能的改善作用不明显.

Therapeutic effects of carvedilol in patients with uremic cardiomyopathy

Objective To explore the therapeutic effects of carvedilol on renal and heart function,and on heart structure of patients with uremic cardiomyopathy.Methods One hundred and four patients with uremic cardiomyopathy were randomly divided into two groups(52 each).Patients in control group were treated with routine therapy,and in carvedilol group were treated with carvedilol 12.5-50mg/d in addition to routine therapy.The total course of treatment was 6 months.The related data of left ventricle were determined by echocardiography,and blood urea nitrogen(BUN),serum creatinine(Scr)and clearance rate of creatinine(Ccr)were measured before and after the treatments.Results After the treatment,the stroke volume(SV),cardiac output(CO)and ejection fraction(EF)were increased,and left ventricular end-diastolic diameter(LVEDD),left ventricular mass(LVM),left ventricular mass index(LVMI),end-diastole interventricular septum thickness(IVST)and end-diastolic left ventricular wall thickness(LVPWT)were decreased in both groups compared with those before the treatment(P<0.01).Furthermore,the levels of SV,EF,and CO were significantly higher and the levels of LVEDD,IVST,LVPWT,LVM and LVMI were significantly lower in carvedilol group than that in control group(P<0.05)after the treatment.The therapeutic effect in carvedilol group was better than that in control group.The levels of Ccr tended to go up,and BUN and Scr tended to decrease,but with no statistically significant difference(P>0.05).Conclusion Carvedilol may effectually inhibit the ventricular remodeling of the patients with uremic cardiomyopathy,improve their left ventricular function and structure,but has no obvious effect on the renal function.