卡维地洛与美托洛尔治疗慢性心力衰竭的对比观察

摘要

Objective To compare the efficacy of carvedilol and metoprolol in treatment of chronic heart failure( CHF ). Methods 86 patients with CHF were randomly divided into carvedilol group( n = 43 )and metoprolol group( n =43 ),respectively received routine treatment combined with carvedilol or metoprolol,the LVEDd,LVEDs, SV and LVEF before and after treatment of the two groups were observed,the postoperative improvement of NYHA grades and perioperative adverse drug reactions( ADR )of the two groups were also analyzed. Results After treatment for 6 months, LVEDd and LVEDs of both groups were decreased( P < 0. 05 ),SV and LVEF were significantly increased( P < 0. 05 ), but carvedilol group showed better effect on LVEDd and LVEF( P <0. 05 ). NYHA grades showed more obvious improvement in carvedilol group than metoprolol group( P <0. 05 ), and the incidence of ADR was also less than metoprolol group( P < 0. 05 ). Conclusion Carvedilol is safe and effective in treating CHF,and its effect is better than metoprolol,thus is worthy of extensive application in clinic.%目的 比较卡维地洛与美托洛尔治疗慢性心力衰竭的疗效.方法 将徐水县人民医院收治的86例慢性心力衰竭患者随机分为卡维地洛组(n=43)和美托洛尔组(n=43),两组在常规抗心力衰竭治疗的基础上分别加用卡维地洛和美托洛尔,观察两组治疗前后左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVEDs)、每搏量(SV)、左心室射血分数(LVEF)变化,观察治疗后纽约心脏病协会(NYHA)心功能改善情况及治疗期间不良反应发生情况.结果 治疗6个月后,两组LVEDd、LVEDs均较治疗前减小(P＜0.05);SV及LVEF均较治疗前显著增加(P＜0.05).但卡维地洛组LVEDd减少及LVEF增加更显著(P＜0.05).卡维地洛组NYHA心功能改善有效率显著高于美托洛尔组(P＜0.05),不良反应发生率显著低于美托洛尔组(P＜0.05).结论 卡维地洛治疗慢性心力衰竭安全、有效,效果优于美托洛尔,值得临床推广应用.