摘要
目的:探讨卡维地洛治疗慢性心力衰竭的长期疗效、安全性和依从性。方法:76例慢性心力衰竭患者随机分为治疗组40例、对照组36例。对照组采取心力衰竭的标准治疗(强心、利尿、扩张血管药和血管紧张素转换酶抑制剂应用);治疗组在标准治疗的基础上加用卡维地洛。观察治疗时间1年,观察治疗前后心功能(NYHA分级)和超声心动图评价左室收缩功能变化以及不良反应。结果:治疗组卡维地洛的平均治疗剂量为(28.6±3.1)mg·d^(-1)。两组治疗前后心功能均得到改善。1年后治疗组左室舒张末期内径(LVEDD)明显减少(57.49±4.61)mm比对照组(60.69±4.71)mm,P<0.01,左室射血分数(EF)明显增加(44.56±11.08)%比(41.32±10.57)%,P<0.01,与对照组比较有统计学意义。在用药剂量个体化的情况下,卡维地洛的不良反应少而轻,未见明显的肝、肾功能损害,血脂和血糖治疗前后比较无明显差异。结论:在心力衰竭标准治疗基础上加用能够耐受的最大剂量的卡维地洛长期治疗慢性心力衰竭有较好的临床疗效,患者安全性和依从性好,能达到改善左心室重构的目的。个体耐受药物剂量有差异。
Objective： To investigate the long-term effect, safety and compliance of carvedilol in treating chronic heart failure. Methods： 76 patients with chronic heart failure were randomly divided into treatment group （n =40） and control group （n = 36）. All the patients were given standard treatment for heart failure, including cardiotonics, diuretics, pimobendane and angiotensin converting enzyme inhibitor （ ACEI）, besides, those in the treatment group were administrated with carvedilol. All the patients were treated for 1 year. The cardiac function [ New York Heart Association （ NYHA ） classification ] , changes of left ventricular systolic function assessed by ultrasonoscope, and adverse reactions were observed before and after treatment. Results： The average dosage of carvedilol in the treatment group was （28. 6 ±3. 1 ） mg · d^-1. The cardiac function after treatment was improved in both groups. After 1 year, the left ventricular end-diastolic dimension （LVEDD） in the treatment group was obviously decreased as compared with that in the control group [ （57.49 ±4.61 ） mm vs. （60. 69 ±4. 71 ） mm, P 〈0.01 ], while the left ventricular ejection fraction （LVEF） was significantly increased [ （44.56 ± 11.08）% vs. （41.32 ± 10. 57 ）% , P 〈0.01 ]. After individualization of dosage for administration, earvedilol had fewer and milder adverse reactions, no damage of liver and kidney functions was observed, and there were no obvious differences in blood lipids and blood glucose before and after treatment. Conclusion： Based on the standard treatments for heart failure, the long-term application of carvedilol of the tolerable maximal dosage has better clinical efficacy on chronic heart failure, the patients have good safety and compliance, and reach the goal of improving the left ventricular remodeling. There is individual difference in the tolerance of drug dosage.
出处
《中国医药导刊》
2007年第4期326-327,330,共3页
Chinese Journal of Medicinal Guide
关键词
心力衰竭
卡维地洛
长期疗效
Heart failure
Carvedilol
Eong-term efficacy
