卡维地洛对充血性心力衰竭患者心功能的影响  

Therapeutical effects of carvedilol on cardiac function in patients with congestive heart failure

作　　者：尚树忠 郑轶 郭三强 顾旭 牛雪彩 刘红 

机构地区：[1]河南省郑州市中医院心内科,450007

出　　处：《实用心脑肺血管病杂志》2002年第5期265-267,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的　探讨卡维地洛对充血性心力衰竭患者心功能的影响。　方法　充血性心力衰竭患者 6 2例(其中扩张性心肌病心力衰竭患者 15例 ,缺血性心脏病心力衰竭患者 4 7例 ) ,左室射血分数 (LVEF)≤ 4 0 % ,心功能(NYHA)Ⅱ～Ⅳ级 ,常规治疗 (洋地黄 ,利尿剂 ,ACEI)基础上随机分为卡维地洛试验组和安慰剂对照组。应用心脏彩色超声仪测定治疗前及治疗后 1个月 ,3个月左室结构和功能指标的变化。观察卡维地洛治疗三个月后对心功能的影响。　结果　卡维地洛平均用量为 2 1 1mg d± 9 6mg d。经过 3个月治疗 ,试验组症状和心功能改善 ,与对照组比较左室射血分数上升 (P <0 0 0 2 ) ,左室收缩末容积下降 (P <0 0 5 ) ;左室舒张末容积与对照组比较虽无统计学差异但与治疗前比较亦明显下降 (P <0 0 5 )。　结论　在洋地黄、利尿剂、ACEI的治疗基础上 ,应用卡维地洛能显著改善充血性心力衰竭患者的心功能 ,改善心室结构 ,且疗效与应用剂量无关。Objective To investigate the therapeutical effects of carvedilol on cardiac function in patients with congestive heart failure Methods 62 patients with congestive heart failure(15 cases of dilated cardiomyopathy and 47 cases of ischemic heart disease) were included in the study All with LVEF≤40% and cardiac function of NYHA class Ⅱ～Ⅳ Patients were treated with conventional therapy(digitalis,diuretics and ACEI) Then carvedilol or placebo was administrated to patients randomly Patients were followed for 3 months to evaluate therapeutical effects of carvedilol on cardiac function as the carvedil group or control group Echocardiography was used to assess changes of left ventricular structure and function before,1 month and 3 months after therapy of cardevilol Results Dose of carvedilol was 21 1mg/d±9 6mg/d Carvedilol group improved in symptom and cardiac function after 3 months with increased LVEF(P<0 002) and decreased LVESV(P<0 05) compared with placebo group LVEDV decreased after carvedilol therapy but the difference between the two groups was not statistically significant Conclusion In patients with congestive heart failure,therapy of carvedilol combined with digitalis,diuretics and ACEI can improve cardiac function and ventricular structure Therapeutial effect of carvedilol was not related with its dose

关 键 词：卡维地洛 充血性心力衰竭 心功能 洋地黄 利尿剂 ACEI CHF 

分 类 号：R541.61[医药卫生—心血管疾病]