卡维地洛与美托洛尔治疗慢性心力衰竭疗效及安全性对比研究

目的比较卡维地洛和美托洛尔对慢性心力衰竭（CHF）的疗效以及安全性。方法将150例CHF患者随机分为卡维地洛组和美托洛尔组,各75例。在常规基础治疗基础上,卡维地洛组患者给予卡维地洛片3.125 mg,1日2次,1周后增加为6.25 mg,之后每2周剂量增加1倍,直至25 mg。美托洛尔组给予酒石酸美托洛尔片6.25 mg,1日2次,每2周剂量增加1倍,直至100 mg,3个月为1个疗程。结果卡维地洛组总有效率为88.00%,显著高于美托洛尔组的74.67%。两组患者心率、收缩压、舒张压、心功能分级、左室舒张末期内径（LVEDd）、肿瘤坏死因子-α（TNF-α）、白细胞介素1（IL-1β）、白细胞介素6（IL-6）水平均显著降低,卡维地洛组降低更明显（P〈0.01）;左室射血分数（LVEF）,LVESd显著升高,卡维地洛组升高更明显（P〈0.05）。结论卡维地洛与美托洛尔都能明显改善CHF的临床症状,卡维地洛的疗效优于美托洛尔。

Comparative Study on Effects and Safety between Carvedilol and Metoprolol in Treatment of Chronic Heart Failure

Objective To compare the curative effect and safety between carvedilol and metoprolol in the treatment of chronic heart failure（ CHF） for guiding their clinical application. Methods 150 cases of CHF were randomly divided into the carvedilol group and the metoprolol group,75 cases in each. On the basis of the conventional treatment,the carvedilol group received carvedilol 3. 125 mg, twice daily, and added to 6. 25 mg after one week, then doubled the dose every two weeks until 25 mg, while the metoprolol group received metoprolol 6. 25 mg, twice daily, doubled the dose every two weeks until 100 mg, with 3 months as a course of treatment. The curative effects were compared between the two groups. Results The total effective rate was 88. 00% in the carvedilol group,which was significantly higher than 74. 67% in the metoprolol group（ P〈0. 05）. The heart rate,systolic pressure,diastolic pressure,heart function classification,LVEDd,TNF- α,IL- 1β and IL- 6 in both groups were decreased significantly,while LVEF and LVESd were increased significantly. The systolic pressure, heart function classification, LVEDd, TNF- α, IL- 1β and IL- 6 in the carvedilol group were significantly lower than those in the metoprolol group, while LVEF and LVESd were significantly higher than those in the metoprolol group. Conclusion Both carvedilol and metoprolol might obviously improve the clinical symptoms of CHF, but the curative effect of carvedilol is better than that of metoprolol.