卡维地洛治疗慢性心力衰竭的临床疗效及其经济学评价  

The clinical effect and economic evaluation of treatment with carvedilol in chronic heart failure

作　　者：郭牧[1] 郭艳萍[1] 郭彩云[1] 

机构地区：[1]宁夏银川市第一人民医院,宁夏银川750001

出　　处：《宁夏医学杂志》2005年第7期469-471,共3页Ningxia Medical Journal

摘　　要：目的旨在观察卡维地洛治疗慢性心力衰竭的临床疗效及其经济学评价。方法44例慢性充血性心力衰竭患者分为卡维地洛组24例和常规治疗组20例,常规组应用传统心力衰竭治疗(血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂、利尿剂、洋地黄制剂),卡维地洛组在传统治疗基础上加用卡维地洛,平均最大剂量为(12.08±3.72)mgd。两组均平均治疗1年,采用超声心动进行疗效观察,并随访1年患者住院次数、年总治疗费用,进行经济学评价。结果治疗后卡维地洛组较常规治疗组心功能明显改善,左室射血分数明显增加{(51.07±9.89)%}{(40.57±8.06)%},左室舒张末径、收缩末径明显缩小{(57.56±7.41)mm(63.74±7.52)mm、(42.80±8.41)mm(51.95±8.76)mm},患者年住院次数及年总治疗费用则明显下降{(1.25±0.46)次/(3.14±1.84)次、(0.64±0.38)万/(1.24±1.86)万}。结论常规治疗充血性心力衰竭基础上加用卡维地洛能够显著缩小左心室舒张及收缩末径,显著提高心功能,降低心肌耗氧量,显著降低患者的年总治疗费用。Objective To evaluate the clinical effect and economic evaluation of carvedilol on patients with chronic heart failure(CHF).Methods 44 patients with CHF were randomly divided into two groups.ACEI or ARB+digoxin+diuretic were given to the 20 patients in the group control (C).The patients in the group carvedilol (T) were treated with carvedilol+ACEI or ARB+digoxin+diuretic.The biggest dosage of carvedilol was 12.08±3.72mg/d.All the patients were followed up for 1 year. LVEDD, LVESD and LVEF were observed by echocardiogramphy, at the same time, noted the times and the cost of being in hospital.Results LVEF of the patients in the group T were increased significantly ｛(51.07±9.89)% vs (40.57±8.06)%,P=0.002｝. Compared with the patients in the group c, the LVEDD and LVESD of the patients in the group T were significantly decreased ｛(57.56±7.41)mm vs (63.74±7.52)mm,P=0.002; (42.80± 8.41) mm vs (51.95 ±8.76) mm,P=0.000｝.The times and the cost of being in hospital were remarkably also decreased ｛(1.25±0.46)time/(3.14±1.84)time; (0.64±0.38)×10~5yuan/(1.24±1.86) ×10~5yuan｝. Conclusion Carvedilol could improve the cardiac function of the patients with CHF with the normal treatment and could reduced the cost of treatment.

关 键 词：卡维地洛 慢性心力衰竭 经济学评价 

分 类 号：R541.6[医药卫生—心血管疾病]