充血性心力衰竭患者心功能及运动耐量与卡维地洛的干预  

Carvedilol for the intervention of the cardiac function and exercise tolerance in patients with congestive heart failure

作　　者：包志宏 韩盈 盛梓松 

机构地区：[1]武装警察部队总医院干部病房,北京市100039

出　　处：《中国临床康复》2005年第15期53-55,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察卡维地洛对充血性心力衰竭患者左心室结构和功能、6min步行距离的影响。方法:纳入2001-12/2003-12武装警察部队总医院干部病房门诊及住院的慢性心力衰竭患者63例,男45例,女18例。纳入的患者症状性心衰时间均>3个月,属稳定性心力衰竭者,且知情同意。患者被随机分为卡维地洛组32例,常规治疗组31例。两组患者年龄、性别、基础疾病和心功能均无明显差异,具有可比性(P>0.05)。所有患者常规给予利尿剂、地高辛、硝酸酯类或血管紧张素转换酶抑制剂治疗,治疗组在此基础上加用卡维地洛,起始剂量3.125mg,2次/d,10～14d剂量加倍,至维持量25mg,2次/d。观察治疗12个月后患者心功能分级、左心室功能指标及6min步行变化。结果:按意向处理分析,63例均进入12个月后结果分析。①卡维地洛组患者治疗后左心室舒张、收缩末期内径和左心室舒张、收缩末期容量明显小于常规治疗组(58.81±6.10)mm,(46.18±5.11)mm,(183.00±18.81)mL,(94.23±18.75)mL;(66.61±5.48)mm,(54.26±5.32)mm,(199.05±17.28)mL,(114.38±18.90)mL,t=2.743,2.450,2.345,2.174,P<0.05。②卡维地洛组患者左心室射血分数明显大于常规治疗组相应数据(48.67±3.15)%,(37.28±2.57)%,t=4.238,P<0.01。③卡维地洛组患者6min步行距离明显长于常规治疗?AIM:To observe the influence of carvedilol on the left ventricular structure and function,and the 6-minute walking distance in patients with congestive heart failure. METHODS:Sixty-three patients with congestive heart failure(45 males and 18 females),who were treated or hospitalized in the Cadre's Sickroom,General Hospital of Armed Police Forces of Chinese PLA from December 2001 to December 2003,were randomly divided into carvedilol group(n =32) and routine therapy group(n=31).All the included subjects were patients with stable heart failure and had symptomatic heart failure for more than 3 months,and they all agreed to participate in the study.There were insignificant differences in the age,gender,general diseases and cardiac function between the two groups,which were comparable(P >0.05).All the patients received routine therapy of diuretic,digoxin,nitric acid ester or angiotensin-converting enzyme inhibitors,besides carvedilol was given to those in the carvedilol group with the initial dosage of 3.125 mg,twice a day,and the dosage was doubled at 10 to 14 days till it was kept at 25 mg,twice a day.After 12-month treatment,the changes of cardiac functional classification,left ventricular functional indexes and the results of 6-minute walking test were observed. RESULTS:According to intention-to-treat analysis,all the 63 cases were involved in the analysis of results after 12 months.①The left ventricular end-diastolic diameter and left ventricular end systolic diameter,left ventricular end-diastolic volume and left ventricular end systolic volume were obviously lower in the carvedilol group [(58.81±6.10) mm,(46.18 ±5.11) mm,(183.00±18.81) mL,(94.23±18.75) mL] than in the routine therapy group [(66.61±5.48) mm,(54.26±5.32) mm,(199.05±17.28) mL,(114.38±18.90) mL](t=2.743,2.450,2.345,2.174,P< 0.05).②Left ventricular ejection fraction in the carvedilol group [(48.67±3.15) %] was markedly higher than that in the routine therapy group[(37.28±2.57)%](t=4.238,P< 0.01).③The 6-minute walking distance was r

关 键 词：充血性心力衰竭患者 卡维地洛 运动耐量 血管紧张素转换酶抑制剂 慢性心力衰竭患者 左心室射血分数 左心室舒张 干预 武装警察部队 6min步行 意向处理分析 步行距离 收缩末期 结构和功能 治疗组 心功能分级 左心室重塑 

分 类 号：R259.416.1[医药卫生—中西医结合] R541.6[医药卫生—中医内科学]