卡维地洛配伍开博通治疗慢性心力衰竭的安全性及疗效观察

目的评价卡维地洛配伍开博通在慢性心力衰竭（CHF）患者中应用的安全性及疗效观察。方法26例CHF患者（男15例，女11例）平均年龄57岁，心动能Ⅱ-Ⅳ级，左室射血分数（LVEF）34％。卡维地洛剂量从3．125mg，2次／d起，只要能耐受，尽可能递增到25～50mg·d。维持，开博通每天，12．5～50mg。共观察6个月，治疗中观察各项相关指标。结果治疗后心功能和6min步行距离较治疗前明显改善，（2．18±0．72）比（3．12±0．69）和（208±164）m比（322±168）m，P〈0．05，心超枰查左室舒张末经（LVEDD）和左室收缩末经（LVESD）明显减少，（63．48±9．7）mm比（57．90±9．01）mm和（51．10±10．90）mm比（46．98±10．48）mm，P〈0．05，LVEF明显增加（28．61±8．8）％比（43．76±10．98）％，P〈0．01，少数人出现咳嗽，血K＋升高，乏力等。结论卡维地洛配伍开通治疗慢性心力衰竭是安全的，能明显改善活动耐量，改善心动能，增加LVEF。

Safety and clinical efficacy of carvedilol and captopril in chronic heart failure treatment

Aim To evaluate the safety and clinical efficacy of earvedilol and captopril in patients with chronic congestive heart failure （CHF）. Methods Twenty-six patients with CHF（ male 15 ,female 11 ） , average age of 57 years old and average EF 34%, underwent carvedilol therapy with a dosage of 3.125mg to 25 -50 mg perday if they were tolerated for six months, combined with eaptopril at a dose of 12.5 - 100 mg once daily for six months. Results After the treatment, NYHA classification and 6 minte walk distance were improved （ 2.18 ±0.72）vs （3.12 ±0.69） ; （208 ± 164） m vs （322 ± 168） m,P 〈0.05 respectively. LVEDD and LVESD measured by echoeardiography reduced （63.48 ±9.7 ）mm vs （ 57.90 ± 9. 01 ） mm ; （ 51.10 ± 10.90 ） mm vs （ 46.98 ± 10.48 ） mm P 〈 0.01, respectively. Left ventrieular eject fraction （LVEF） increased （28.61 ± 8.8 ） % vs （43.76 ±10.98 ） % , P 〈 0. 01. Cough and serum potassium increased （P 〈 0.05 ）. Conclusion The application of carvedilol and captopril to the treatment of ehronie heart failure is safe and effective.