卡维地洛对扩张型心肌病QT间期离散度及室性心律失常变化的影响  

Effect of carvedilol on QT intenals dispersion and ventricular arrhythmias in the patients with dilated cardiomyopathy

作　　者：张雪芳 王良玉[2] 陈纪平[2] 王少彬[3] 张玉[3] 

机构地区：[1]广东省澄海市人民医院心电图室,515800 [2]广东省汕头市中心医院心内科,515031 [3]汕头大学医学院第一附属医院心内科,515041

出　　处：《实用医学杂志》2004年第3期268-270,共3页The Journal of Practical Medicine

摘　　要：目的 :探讨卡维地洛治疗对扩张型心肌病 (DCM )患者心电图QT间期离散度 (QTd)及室性心律失常的影响。方法 :80例DCM患者分为基础治疗组 (A组 ,40例 )及基础治疗加卡维地洛治疗组 (B组 ,40例 ) ,B组在基础治疗上加服卡维地洛 10mg ,2次 /d ,疗程 9个月。治疗前后应用 2 4h动态心电图和多普勒超声心动图 ,观测QTd、QTcd、HR、室性心律失常 (VA )如室性早搏 (PVC)、非持续性室性心动过速 (NSVT) )的发生情况、左心室射血分数(LVEF)。结果 :B组QTd、QTcd及室性心律失常 (VA )发生率均较A组显著降低 (P均 <0 0 1) ,左室射血分数(LVEF)较A组明显提高 (P <0 0 1) ,而HR、血压无明显变化 (P >0 0 5 )。提示B组疗效优于A组。结论 :DCM患者长期应用卡维地洛可显著降低QTd、QTcd及VA的发生率 ,改善心功能 。Objective To evaluate whether the addition of carvedilol to conventional therapy in dilated cardiomyopathy (DCM) patients was associated with further benefits in shortening QT intervals dispersions(QTd) and reducing ventricular arrhythmias (VA). Methods Eighty DCM patients were randomly allocated to two groups (A and B group). A group (conventional therapy group), 40 cases ,with commonly used drugs of cardicglycoside ,diuresis and angiotens inconverting enzyme inhibitor medicine. B group (conventional therapy plus carvedilol group), 40 cases, patients were treated with conventional therapy and carvedilol 10 mg, bid. The course of treatment was 9 months. Before and after the treatment, 24 hour Holter was used to monitor HR,VA such as PVC and NSVT, and Doppler ultrasound cardiogram was used to measure left ventricular ejection fraction(LVEF). Results After 9 month's treatment, LVEF was significantly improved, QTd and QTcd were significantly shortened and VA was markedly reduced in the carvedilol group compared with that in the conventional therapy group ( P <0 05), but there was no significantly difference between the two groups in the HR and the blood pressure ( P >0 05). Conclusion Carvedilol coupled with commonly used cardiacglycoside, diuresis and ACEI medicine has a better curative effect in shortening QTd and QTcd, reducing ventricular arrhythmias and improving left ventricular function in dilated cardiomyopathy.

关 键 词：卡维地洛 扩张型心肌病 QT间期离散度 室性心律失常 左心室射血分数 超声心动图 

分 类 号：R541.7[医药卫生—心血管疾病]