摘要
目的探讨卡维地洛对冠心病充血性心力衰竭患者左室功能及运动耐量的影响。方法选择冠心病心力衰竭患者71例,左室射血分数(LVEF)≤45%,心功能(NYHA)Ⅱ-Ⅳ级,在常规药物治疗[洋地黄、利尿剂、血管紧张素转换酶抑制剂]的基础上将其随机分为卡维地洛组和对照组。观察治疗前及治疗6个月后血流动力学、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)及6分钟步行距离(6-MWD)等指标的变化,并对心功能及运动耐量进行评估。结果经过6个月治疗,卡维地洛组患者症状和心功能改善,与对照组比较LVEF上升[(44.38±6.08)%及(38.57±7.32)%,P<0.01],LVEDD、LVESD、血压及心率明显下降(P<0.05),6分钟步行距离与对照组及治疗前相比有所提高(P<0.01)。结论在洋地黄、利尿剂、ACEI治疗的基础上,应用卡维地洛能显著改善冠心病心力衰竭患者的心功能,提高运动耐量。
Objective To investigate the therapeutical effects of carvedilol on cardiac function and exercise tolerance in patients of coronary heart disease with cardiac dysfunction. Methods 71 patients of coronary heart disease with cardiac dysfunction were recruited in the study. All subjects＇ LVEF were≤45% and their cardiac function were class Ⅱ-Ⅳ. With a basic conventional therapy（ digitalis,diuretics and ACEI）, patients were randomly divided into carvedilol and control group. After 6-month＇s treatment, changes of hemodynamics and 6-minute walking distance were assessed. Echocardiography was used to assess the changes of left ventricular structure and function before and after treatment of cardevilol. Resuits In comparison with the control group, The symptom and cardiac function improved in carvedilol group after 6-month＇ s treatment. LVEF increased [ （44.38 ± 6.08 ） % vs （38.57 ± 7.32） % ,P 〈 0.01 ], LVEDD, LVESD,blood pressure and heart rate decreased （ P 〈 0.05 ）. The 6-MWD of patients in carvedilol group was significantly increased when compared with pre-trestment and control group（ P 〈 0.01 ）. Conclusion In patients of coronary heart disease with cardiac dysfunction,therapy of carvedilol combined with digitalis,diuretics and ACEI can improve cardiac function and exercise tolerance.
出处
《临床内科杂志》
CAS
2008年第9期613-615,共3页
Journal of Clinical Internal Medicine
关键词
卡维地洛
心力衰竭
超声心动图
心功能
Carvedilol
Heart failure
Echocardiography
Cardiac function
