卡维地洛与比索洛尔治疗老年慢性心力衰竭的疗效对比

目的 比较卡维地洛与比索洛尔治疗老年慢性心力衰竭(CHF)的效果差别.方法 华北石油总医院心内科收治的CHF患者126例,随机分为两组,卡维地洛组(n=63),比索洛尔组(n=63).卡维地洛组给予卡维地洛3.125 mg,每天2次,比索洛尔组给予比索洛尔1.25 mg,每天1次,应用超声心动图测量治疗前和治疗6个月后左心室舒张末内径(LVEDD)和左心室射血分数(LVEF)变化,纽约心脏病协会(NYHA)心功能分级,6分钟步行距离,收缩压(SBP)和舒张压(DBP);用放射免疫法测定血浆中脑钠肽(BNP)和N末端B型利钠肽原(NT-proBNP)浓度.结果 卡维地洛组在NYHA心功能分级改善上优于比索洛尔组,总有效率分别为96.9%(62/64)、70.9%(44/62)(P＜0.05).两组治疗后的LVEDD、BNP、NT-proBNP、SBP和DBP比治疗前均有明显降低(P＜0.01或＜0.05),而LVEF及6分钟步行距离较治疗前有明显升高(P＜0.05);两组治疗后各项指标比较差异均有统计学意义(P＜0.01或＜0.05).结论 卡维地洛及比索洛尔均能明显改善心功能,但卡维地洛的疗效更为显著.

Efficiency comparison between carvedilol and bisoprolol in senile patients with chronic diastolic heart failure

Objective To compare the efficiency difference between carvedilol and bisoprolol in the treatment of chronic diastolic heart failure. Methods This study enrolled 126 consecutive patients with chronic diastolic heart failure who were admitted to the General Hospital of Petro China Huabei Oilfield Company. All eligible patients were divided into two groups： carvedilol group （ n = 63）,bisoprolol group （ n ： 63）. Patients in carvedilol group were administered carvedilol 3. 125 mg bid. Patients in bisoprolol group were administered bisoprolol 1.25 mg qid. At admission,and six months of treatment, echocardiography was used to measure the changes of left ventricular end-diastolic diameter （LVEDD） and left ventricular ejection fraction（LVEF）, NYHA heart function classification and the results o＇f six- minute walking test were evaluated, and plasma BNP and NT-proBNP concentration were measured by radioimmunoassay. Results Comparison of two drugs on NYHA classification： the total efficacy in carvedilol group and bisoprolol group was 96.9 % （62/64） and 70.9 % （44/62）, respectively. The efficacy in carvedilol group was higher than that in bisoprolol group（ P d0.05）. Comparison of two drugs on heart function： LVEDD in earvedilol group was lower than that bisoprolol group （ P 〈0.01）. LVEF in carvedilol group was significantly higher than that of bisoprolol group （ P 〈0.01）. Comparison of two drugs on the results of six-minute walking test： the distance in carvedilol group was longer than that of bisoprolol group（ P 〈0.05）. BNP and NT-proBNP in two groups were significantly decreased with the improvement of cardiac function. The BNP and NT-proBNP of carvedilol group decreased significantly compared with those of bisoprolol group. Conclusion Both carvedilol and bisoprolol could improve the heart function in senile patients with chronic diastolic heart failure,and carvedilol is more effective.