卡维地洛在老年充血性心力衰竭治疗中的应用  

The efficacy of carvedilol in the treatment of congestive heart failure in the elderly

作　　者：周秀娟[1] 李拥军[1] 戴振华[1] 高甬东[1] 

机构地区：[1]南京医科大学第一附属医院老年医学科,210029

出　　处：《江苏医药》2005年第6期413-415,共3页Jiangsu Medical Journal

基　　金：江苏省科委社会发展项目基金(BS2000046)

摘　　要：目的观察卡维地洛治疗老年充血性心力衰竭(心衰,CHF)的疗效和安全性。方法选择老年CHF患者45例,随机分为心衰常规治疗组(22例)和卡维地洛治疗组(23例),后者在常规抗心衰治疗基础上加用卡维地洛,从小剂量开始,渐增至最大耐受量,疗程6个月。两组治疗前和治疗3、6个月末使用超声心动图分别测定左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左心室射血分数(LVEF),并观察6min步行距离,记录不良反应。结果老年CHF患者用卡维地洛治疗后,LVEDD、LVESD和LVEF的改善均优于常规治疗组(P<0.01),6min步行距离增加较常规治疗组更为显著(P<0.01)。治疗期间无严重不良反应出现。结论在心衰常规治疗基础上加用卡维地洛治疗老年心衰患者耐受量虽偏小,但可明显改善心功能,提高运动耐量,缩小心室,改善左室重构。Objective To evaluate the safety and clinical efficacy of carvedilol in the treatment of congestive heart failure(CHF) in elder patients.Methods Forty five elderly patients with CHF were devided randomly into CHF treatment group(group Ⅰ,n=22) and carvedilol treatment group(group Ⅱ,n=23).The conventional therapy was given to the patients in group Ⅰ.In group Ⅱ,carvedilol was added to the conventional therapy as in group Ⅰ,which was titrated from a low dose to a maximal tolelance dose for 6 morths.Left ventricular end-diastolic diameter(LVEDD),Left ventricular end-systolic diameter(LVESD),Left ventricular eject fraction(LVEF) and 6-minute walk distance were measured before and after 3,6 months treatment respectively.Results After treatment,LVEDD and LVESD in group Ⅱ were significantly decreased compared with those in group Ⅰ.The increase of LVEF and 6-minute walk distance in group Ⅱ was greater than that in group Ⅰ.There were no severe side effects found in group Ⅱ.Conclusion On the basis of conventional therapy of CHF,addition of even smaller dose of carvedilol could ameliorate cardiac function,reduce cardiac chamber and improve myocardium remodeling,and increase exercise capability in the elderly patients with CHF.

关 键 词：老年充血性心力衰竭 卡维地洛 左心室舒张末期内径 左心室射血分数 CHF患者 严重不良反应 治疗基础 步行距离 最大耐受量 超声心动图 治疗组 方法选择 收缩末期 LVEF 治疗期间 心衰患者 运动耐量 左室重构 安全性 抗心衰 

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]