卡维地洛治疗扩张型心肌病合并心房纤颤27例临床观察

目的 观察卡维地洛治疗扩张型心肌病合并慢性持续性心房纤颤的临床疗效。方法 入选的27例扩张型心肌病合并房颤患者在原有强心、利尿、扩血管等治疗基础上加用卡维地洛，从3．125mg，2次／d开始，每2周剂量增加1倍，直至目标剂量达12．5mg，2次／d，或最大耐受量，疗程6个月。治疗前后观察患者心功能、血压、心率，并且均进行超声心动图、24h动态心电图检查及6min步行试验（6mWT），评价药物疗效。结果 卡维地洛治疗6个月后患者的心功能好转，血压、心室率降低，6min步行距离增加，左室舒张、收缩末期内径缩小，左室射血分数增加（P〈0．05）。结论 长期服用卡维地洛可使扩张型心肌病合并房颤患者的心功能改善，运动耐量提高。

Clinical study on the effect of cavedilol on treatment in 27 patients with dilated cardiomyopathy complicated atria fibrillation

Objective To observe the clinical effects of cavedilol in patients diagnosed with dilated cardiomyopathy in chronic established atria fibrillation. Methods 27 patients with dilated cardiomyopathy complicated atria fibrillation were commenced on cavedilol in addition to the ongoing therapy for example digoxin, diuretic and angiolensin-converting enzyme in starting dose of 3. 125 mg twice daily,then double the doses every 2 weeks until the patients couldn＇ t endure, or achieved 12.5 mg twice daily desired dosage. Heart rate, blood pressure were recorded and cardiac function status were evaluated before and 6 months after therapy. Doppler, Holter and 6 minutes walk test（6 mWT）were done in pretreatment and post treatment respectively. Results After 6 months treatment, cardiac function was improved,the heart rate and blood pressure decreased, LVESD and LVEDD also reduced, while LVEF and the 6 minute walking distance improved （ P 〈 0. 05 ）. Conclusion Carvedilol can improve the heart function and exercise tolerance of the patient with dilated cardiomyopathy complicated atria fibrillation.