国产卡维地洛与美托乐尔治疗心力衰竭对心肺功能的影响  

Effects of carvedilol and metaprolol on cardiac and pulmonary function in the treatment of heart failure

作　　者：韩丽瑄[1] 王凤芝[1] 李彦红[1] 李黎[2] 郝林娃[2] 宋涛[2] 马京炬[3] 

机构地区：[1]山西医科大学第二医院心内科,030001 [2]山西医科大学第二医院综合检查科,030001 [3]山西省临汾市人民医院心内科

出　　处：《中国药物与临床》2003年第3期214-218,共5页Chinese Remedies & Clinics

摘　　要：目的　对比观察卡维地洛和美托乐尔治疗慢性收缩性心力衰竭对心、肺功能的影响及其安全性。方法　将 34例在常规心力衰竭治疗 (利尿剂 +地高辛 +ACEI/AⅡ受体拮抗剂 )的基础上 ,心功能为Ⅱ～Ⅲ级及病情稳定的Ⅳ级非瓣膜病变慢性收缩性心力衰竭患者 ,随机分为卡维地洛组 (A组 )、美托乐尔组 (B组 )。采用小剂量逐渐递增给药 ,两组剂量分别为A组 :(2 1 3± 2 8)mg ;B组 :(65± 2 9)mg。治疗前及治疗后 3个月分别评定心功能级别 ,检查血、尿常规 ,血糖 ,血脂 ,肝、肾功能 ,电解质 ,超声心动图 ,气道激发试验以及 6min步行距离 ,并进行治疗前后及组间的对比。结果　两组患者经加用 β 受体阻滞剂 (β B)治疗 3个月后 ,心力衰竭症状、心功能分级、血流动力学指标、运动耐量均较用药前明显改善 ,且组间比较差异无显著性。美托乐尔较卡维地洛有较显著的降心率作用 ,卡维地洛虽增加气道阻力 ,但不足以影响气道的阻塞程度和肺的总通气功能。两药均增高甘油三酯 ,组间比较差异无显著性。未见两药对血细胞 ,电解质 ,肝、肾功能 ,血糖有影响。结论　卡维地洛和美托乐尔对治疗慢性收缩性心力衰竭均有较好疗效。Objective To assess the safety and the effect of carvidilol and metaprolol on cardiac and pulmonary function in the treatment of chronic systolic heart failure.Methods Thirty four patients with chronic systolic heart failure were in the study,who were conventionalty treated with carvedilol or metaprolol in addition to ACE inhibitors,furosemide,and digoxin,whose New York Heart Association (NYHA) classes were stable Ⅱ～Ⅲ classes or Ⅳ class.All of them did not have valve diseases.Then they were randomly divided into carvedilol group (A group) and metaprolol group (B group).Both groups were titrated from low dose,and the average doses of two groups were (21 3±2 8) mg and (65±29) mg.NYHA class,blood test,urine test,two dimensional echocardiography,airway provocative test and 6 minute walking test were carried out at baseline and after a three month therapy.Results All patients were improved in NYHA class,hemodynamic state and exercise capacity after a three month therapy and no differences between two groups;metaprolol had more remarkable effect of reducing heart rate than carvedilol;carvedilol increased the airway resistance,but not enough to affect airway obstruction degree and total pulmonary ventilation volume;both carvedilol and metaprolol can make triglyceride high,but no effects on blood cell,electrolyte,liver and kidney function and blood sugar.Conclusion Both carvedilol and metaprolol have good curative effects in the treatment of chronic systolic heart failure.

关 键 词：卡维地洛 美托乐尔 治疗 心力衰竭 心肺功能 影响 

分 类 号：R541.6[医药卫生—心血管疾病]