卡维地洛联合地高辛治疗心力衰竭并心房颤动的效果  

EFFICACY OF COMBINATION OF DIGOXIN AND CARVEDILOL ON HEART FAILURE PATIENTS WITH ATRIAL FIBRILLATION

作　　者：强力[1] 马立学[1] 

机构地区：[1]青岛市第八人民医院心内科,山东青岛266100

出　　处：《齐鲁医学杂志》2003年第4期375-376,共2页Medical Journal of Qilu

摘　　要：①目的　评估联合应用卡维地洛与地高辛治疗心力衰竭并心房颤动的疗效和安全性。②方法　 4 8例心力衰竭并心房颤动病人随机分为两组 ,应用地高辛 0 .2 5mg/d治疗 1周后 ,一组维持原治疗 ,另一组联用卡维地洛 (5～ 2 0mg/d)治疗 3个月。治疗前后分别行超声心动图和动态心电图检查 ,评价左室功能和心室率。 ③结果治疗前后卡维地洛联用地高辛组的静息心室率分别为 (98.7± 7.0 )min-1和 (76 .3± 6 .0 )min-1,治疗前后比较差异有显著性 (t=15 .6 8,P <0 .0 1) ,其心室率变化较对照组明显 (t=5 .4 9,P <0 .0 1)。联合治疗组的左室射血分数(LVEF)、左室短轴缩短率 (LVFS)、心排血量 (CO)和E/A比值 (E/A)有明显改善 ,两组比较差异有显著性 (t =3.4 6～ 37.6 7,P <0 .0 1)。两组病人治疗前后均未发现明显副作用。Objective To evaluate the efficacy and safety of combination use of digoxin and carvedilol on heart failure patients accompanying atrial fibrillation. Methods Forty-eight heart failure patients with atrial fibrillation were randomly divided into 2 groups. In the first week, digoxin (0.25 mg/d) was given to all patients, and then for the next three months the controls continued to take digoxin while the patients in the experimental group took both digoxin and carvedilol (5-20 mg/d). Echocardiography and Holter ECG monitoring were used to test and evaluate LV function and ventricular response of the patients before and after experiment. Results The rest ventricular rates of the patients in the experimental group were (98.7±7.0) min -1 and ( 76.3±6.0) min -1 , respectively, showing significant difference before and after treatment (t=15.68, P<0.01). The changes were significant compared with the controls (t=5.46, P<0.01). The LVEF, LVFS, CO and E/A of the patients in the experimental group were significantly improved compared with the controls (t=3.46-37.67, P<0.01). No evident side effects were found in both groups. Conclusion Combination use of digoxin and carvedilol was effective for patients with heart failure accompanying atrial fibrillation.

关 键 词：心力衰竭 心房颤动 卡维地洛 地高辛 治疗 疗效 安全性 

分 类 号：R541.6[医药卫生—心血管疾病] R541.75[医药卫生—内科学]