卡维地洛和美托洛尔对老年慢性心力衰竭患者心脏功能及脑钠肽、C反应蛋白的影响  

Effects of Carvedilol and Metoprolol on Cardiac Function,Brain natriuretic peptide,and C-reactive protein in Patients with Chronic Heart Failure

作　　者：李柏刚[1] 平鑫[1] 刘文术[1] 

机构地区：[1]黑龙江省齐齐哈尔市第一医院,黑龙江齐齐哈尔161000

出　　处：《实用预防医学》2009年第3期855-857,共3页Practical Preventive Medicine

摘　　要：目的探讨卡维地洛和美托洛尔对老年充血性心力衰竭(CHF)患者心脏功能、脑钠肽(BNP)、C反应蛋白(CRP)水平的影响。方法270例老年CHF患者,分为卡维地洛组(n=150)和美托洛尔组(n=120)。研究组在常规治疗基础上加用卡维地洛或美托洛尔治疗12周,对比观察心脏结构、心功能、脑钠肽(BNP)、C反应蛋白(CRP)水平和临床疗效。结果卡维地洛组和美托洛尔组患者治疗后较治疗前LVEF明显上升,LVEDd明显下降,外周血中BNP、CRP水平明显下降(P<0.05)。卡维地洛组较美托洛尔组在LVFF、LVEDd及BNP、CRP改善更明显(P<0.05)。治疗12周后,两组心功能均有改善,卡维地洛治疗组总有效率为94.7%,高于美托洛尔组的73.3%,差异有统计学意义(P<0.05)。结论卡维地洛能显著改善老年CHF患者心功能、逆转心室重塑、降低异常升高的BNP、CRP,优于美托洛尔。Objective To compare the effects of carvedilol and metoprolol on cardiac function, brain natriuretic peptide, and C- reactive protein in senile patients with chronic heart failure. Methods Totally 270 patients with congestive heart failure（CHF）were randomly assigned into carvedilol group （n = 150） and metoprolol group （n = 120）. The curative effects of the two groups were observed after a period of 12 - week treatment with carvedilol or metoprolol. BNP and CRP con- centrations were determined and cardiac function parameters were measured before and after＂ treatment by echocardiography. Results After 12 weeks of treatment, the parameter of LVEF was significantly improved, LVEDd and serum levels of BNP and CRP were significantly decreased in the two groups（P〈 0.05）. LVEF, LVEDd and serum levels of BNP and CRP were significantly improved in carvedilol group than those in metoprolol group（ P〈 0.05）. Cardiac function was improved in the two groups, the total effective rate of carvedilol group （94.7%） was higher than that of metoprolol group （73.3%）, the differ- ence was statistically significant（P〈 0.0.5）. Conclusions Carvedilol is superior to metoprolol in significant improvement of cardiac function in elderly patients, reversion of ventricular remodeling and reduction of production of BNP and CRP.

关 键 词：卡维地洛 美托洛尔 老年 心力衰竭 脑钠肽 细胞因子 

分 类 号：R541.6[医药卫生—心血管疾病]