美托洛尔与卡维地洛在慢性心力衰竭中耐受性的比较  

A comparison of tolerance between metoprolol andcarvedilol in patients with chronic heart failure

作　　者：冯海明[1] 江隆福[1] 蔡小婕[1] 许兆军[1] 王虹[1] 陈玉峰[1] 陈国方[1] 

机构地区：[1]宁波市第二医院心内科,浙江宁波315010

出　　处：《临床心血管病杂志》2004年第12期713-715,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨美托洛尔与卡维地洛在慢性心力衰竭中的耐受性。方法 :186例慢性心力衰竭患者随机分成美托洛尔组与卡维地洛组 ,在常规抗心力衰竭治疗基础上从小剂量开始逐渐加用美托洛尔与卡维地洛 ,直至目标剂量维持。结果 :美托洛尔组平均维持剂量为 (81.1± 33.5 )mg/d ,坚持维持量者 80例 (84 .2 % ) ,卡维地洛组平均维持剂量为 (34.9± 14 .6 )mg/d ,坚持维持量者 78例 (85 .7% ) ,卡维地洛组较美托洛尔组更易达最大靶剂量 (5 8.2 %∶2 .1% ,P <0 .0 1) ,且剂量调整时间短 [(31.6± 9.4 )d∶(4 6 .7± 17.2 )d ,P <0 .0 1]。美托洛尔组降低心率 (16 .2± 3.5 )次 /min ,卡维地洛组为 (13.8± 4 .1)次 /min(P <0 .0 1)。美托洛尔组降低收缩压 (12 .9± 3.7)mmHg(1mmHg =0 .133kPa) ,舒张压 (6 .7± 2 .6 )mmHg ,卡维地洛组分别为 (14 .4± 4 .1)mmHg和 (7.9± 2 .9)mmHg (P <0 .0 5 )。结论 :慢性心力衰竭患者对美托洛尔和卡维地洛都具有良好的耐受性 ,美托洛尔对心率的影响较大 ,而卡维地洛对血压的影响较大 ,卡维地洛比美托洛尔更易达到最大靶剂量 。Objective:To compare the tolerance between metoprolol and carvedilol in patients with chronic heart failure(CHF).Method: One hundred and eighty-six CHF patients randomly received metoprolol or carvedilol from low dosage at the basis of regular regimen to the dosage which was increasingly added to target dose. Result: The patients treated with carvedilol were more easy to reach the target dosage and the time of adjusting dosage were shorter than those treated with metoprolol [( 2.1% ∶ 58.2%, P< 0.01 and ( 46.7± 17.2)d ∶( 31.6± 9.4)d,P< 0.01)].The average doses were ( 81.1± 33.5)mg/d in metoprolol group and( 34.9± 14.6)mg/d in carvedilol group. The decreases of heart the in metoprolol group was greater than in carvedilol group [( 16.2± 3.5)次/min ∶( 13.8± 4.1)次/min,P< 0.01].Compared with metoprolol, patients treated with carvedilol showed larger decreases in SBP [( 14.4± 4.12)mmHg ∶( 12.9± 3.72)mmHg, P< 0.05] and DBP [( 7.9± 2.96)mmHg ∶( 6.7± 2.56)mmHg,P< 0.05].Conclusion:Both meteprolol and carvedilol had good tolerance in CHF patients. Metoprolol produced greater effect in HR but less effect in BP. Carvedilol was more easy to be added to the target dose than metoprolol.The time of adjusting dosage was shorter in carvedilol group than in metoprolol group.

关 键 词：美托洛尔 卡维地洛 心力衰竭 充血性 药物耐受性 

分 类 号：R541.6[医药卫生—心血管疾病]