摘要
目的:比较卡维地洛和美托洛尔治疗急性心肌梗死(AMI)伴心功能不全患者的疗效和安全性。方法:107例AMI伴左心室收缩功能减退患者以1:1随机分为卡维地洛组(54例)和美托洛尔组(53例)。测定治疗前后临床心功能分级、血压、心率、左心室功能及肾功能和血糖、血脂水平。结果:两组治疗后NYHA心功能分级均改善,左心室射血分数增高,收缩末期容量降低(P均＜0.05)。治疗后,血糖、肌酐变化值卡维地洛组与美托洛尔组比较有统计学差异(P＜0.05),而总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)变化值卡维地洛组与美托洛尔组比较无显著性差异。结论:卡维地洛治疗AMI伴左心功能不全患者安全,疗效与美托洛尔相似,但前者对糖代谢和肾功能可能有益。
Objective： To compare the effects of carvedilol and metoprolol in acute myocardial infarction（AMI） patients with left ventricular（LV） dysfunction. Methods：One hundred and seven AMI patients with LV dysfunction were randomly allocated to receive carvedilol（Carvedilol group, n=54） or metoprolol（ Metoprolol group, n=53） treatment. Clinical characteristics, NYHA functional class, LV ejection fraction, and serum biochemical changes were compared between the two groups before and after treatment. Results： Both therapeutic regimens significantly improved patients＇ NYHA functional class （from 2.7 to 2.0 in Carvedilol group and from 2.9 to 2.1 in Metoprolol group, P〈0. 001）, LV ejection fraction was increased in both groups （from 0. 44 to 0. 52 in Carvedilol and from 0.43 to 0.52 in Metoprolol group respectively）, and end-systolic volume was decreased （from 59ml to 53ml in Carvedilol and 55ml to 51ml in Metoprolol group respectively）. In Carvedilol group, serum glucose and creatinine levels were significantly reduced as compared to the Metoprolol group after treatment. Conclusions： Despite similar therapeutic effects in improving LV function, carvedilol has better effects on glucose metabolism and renal function than metoprolol in treating AMI patients with LV dysfunction.
出处
《国际心血管病杂志》
2006年第1期52-55,共4页
International Journal of Cardiovascular Disease
基金
上海罗氏制药有限公司的资助
关键词
卡维地洛
美托洛尔
急性心肌梗死
心功能不全
Carvedilol
Metoprolol
Acute myocardial infarction
Cardiac dysfunction
