卡维地洛用于慢性心肾联合损害患者的耐受性和安全性  

The tolerance and safety of carvedilol on chronic heart failure patients with chronic renal dysfunction

作　　者：骆雷鸣[1] 范利[1] 薛浩[1] 杨雪[1] 史军[1] 朱兵[1] 叶平[1] 

机构地区：[1]中国人民解放军总医院,北京100853

出　　处：《药物不良反应杂志》2005年第6期408-411,共4页Adverse Drug Reactions Journal

摘　　要：目的:评价卡维地洛在心、肾联合损害治疗中的耐受性和安全性。方法:选择慢性心力衰竭(CHF)合并慢性肾功能不全(CRF)患者68例,在常规抗心衰治疗的基础,包括应用洋地黄、血管紧张素转化酶(ACE)抑制药、利尿剂上,加用第三代β受体阻滞剂卡维地洛,最大剂量37.5mg/d,疗程6个月。观察卡维地洛治疗的耐受性和不良反应。结果:卡维地洛改善CHF+CRF患者心输出量和肾小球滤过功能,药物耐受性好,68例患者全部完成6个月治疗,其中22例达最大设定剂量37.5mg/d,平均剂量为25.2mg/d。药物不良反应共发生为19例,其中需要紧急处理的严重不良反应4例,均为可逆性。结论:第三代β受体阻滞剂卡维地洛在改善心肾联合损害患者的心、肾功能同时,耐受性好,不良反应发生率低。Objective： To estimate the tolerance and safety of carvedilol on chronic heart failure （CHF） patients with chronic renal dysfunction （CRD）. Methods： 68 CHF patients with CRD were chosen to receive carvedilol therapy in addition to sufficient anti-heart failure treatment, including digitalis, ACE inhibitors and diuretics. The carvedilol was given from 6.25 mg to 37.5 mg each day, and the course of treatment lasted six months. The tolerance and adverse effects of carvedilol were investigated. Results： Carvedilol is well tolerated, for all 68 CHF patients with CRD being under treatment through the end of study. Carvedilol significantly improved cardiac output and renal filter function. 22 patients reached the target dose of 37.5mg/day, and the average dose tolerated by patients was 25.2 mg/day. The incidence of adverse effects occurred in 19 cases, most of them were minor and reversible, and only 4 of them were serious and needed urgent management. Conclusion： The third generation of beta-blocker, carvedilol, could improve cardiac and renal function in chronic heart failure patients with chronic renal dysfunction. Moreover, it is safe and tolerant.

关 键 词：卡维地洛 慢性心力衰竭 慢性肾功能不全 耐受性 安全性 

分 类 号：R541.6[医药卫生—心血管疾病] R692.5[医药卫生—内科学]