卡维地洛治疗慢性充血性心力衰竭的临床观察卡维地洛治疗心力衰竭作用机制

卡维地洛治疗慢性充血性心力衰竭的临床观察卡维地洛治疗心力衰竭作用机制 【摘要】 目的 观察卡维地洛治疗慢性充血性心力衰竭的临床效果和毒副作用。 方法 各种原因所致慢性心力衰竭患者70例，在常规治疗、病情基本稳定的基础上，随机分为对照组和观察组各35例。对照组予强心甙、利尿药、血管扩张剂和血管紧张素转换酶抑制剂或血管紧张素受体拮抗剂治疗，观察组在对照组治疗基础上加用卡维地洛治疗，初始剂量2.5 mg，2次/d，每2周剂量倍增1次，直至最大剂量20 mg， 2次/d。治疗持续3个月以上。 结果 卡维地洛组心功能改善的临床显效率48.6%和总有效率91.4%，均高于对照组(28.6%、68.6%)，总有效率差别有统计学意义( P 【关键词】 卡维地洛;慢性充血性心力衰竭;心功能 The Clinical Observation of Carvedilol in Treatment of Chronic Congestive Heart Failure BAO Min, GUO hua. The Hospital of Dunhua City,jilin Dunhua 133700,China 【Abstract】 Objective To observe the clinical effect of carvedilo1 in treatment of chronic congestive heart failure and its toxic and side reaction. Methods 70 cases of chrome congestive heart failure caused by various factors were randomly and equally divided into two groups.The treatment group was given cardiac glycoside，diuretics，vasodilators and an gi0-tensin-eonveting enzyme inhibitors，and the observation group was treated with carvedilol on the basis of the above mentioned drugs.The initial dosage of carvedilol was 2.5 mg，bid，and duration of treatment was over 3 months. Results In the observation group the excellent effective rate and the overall effective rate were 48.6% and 91.4%，respectively， an d higher than that in control group(28.6% and 68.6%,respectively).The statistical difference was significant between the two groups( P O.05)in the overall effective rate.The LVEF and LVEDD improved in the observation group pared with that before treatment and the difference was significant statistically. Conclusion Carvedilo1 has dramatic effect of treating chronic congestive heart failure，and the toxic and side reaction is mild.So it is worth spreading application in the usual treatment of chronic congestive heart failure. 【Key words】 Carvedilol;Chronic congestive heart failure;Heart function 慢性充血性心力衰竭(CHF)是大多数心血管疾病的最终归宿，也是最主要的死亡原因。心力衰竭时机体的代偿机制虽然在早期能维持心脏排血功能，但在长期发展过程中将对心肌产生有害的影响，加速患者的死亡，代偿机制中交感神经激活是一个重要的组成部分。卡维地洛作为新的非选择性并有扩张血管作用的受体阻滞剂，用于心力衰竭治疗，可显著降低死亡率。本研究是观察卡维地洛治疗慢性心衰的临床疗效及安全性。 1 资料与方法 1.1 一般资料 选择xx年12月至xx年12月在我院住院的慢性充血性心力衰竭患者70例，包括冠心病22例，高血压心脏病20例，扩张型心肌病20例，风湿性心脏病8例。其中男40例，女30例，年龄4276岁，平均年龄(58.211.3)岁。常规治疗病情稳定后，随机分为卡维地洛组和对照组各35例，两组性别、年龄、病程、心衰病因及心功能等临床资料无统计学差异。 入选标准按纽约心脏协会(NYHA)分级，心功能NYH