摘要
目的探讨卡维地洛对慢性心力衰竭患者左心功能及脑钠肽水平的影响。方法选择2012年1月~2014年1月在我院治疗的慢性心力衰竭患者64例,分为两组,两组患者均给予强心、利尿剂、血管紧张素转换酶抑制剂（ACEI）等常规治疗,病情相对稳定后,对照组予利尿剂、ACEI和地高辛等常规抗心力衰竭治疗,研究组加用卡维地洛。起始剂量为3.125 mg,2次/d,每2周剂量增加1倍,直至达到目标剂量25 mg,2次/d;若患者不能达到目标剂量则以最大耐受量为负荷量。疗程6个月。观察比较两组患者的疗效以及两组患者治疗前后BNP、LVEDD、LVEF的变化情况。结果研究组患者治疗后总有效率为90.6%,对照组治疗后总有效率为71.9%,两组疗效比较,差异具有统计学意义（P〈0.05）。研究组和对照组治疗后的LVEDD、LVEF及BNP治疗后均较治疗前显著改善（P〈0.01）,且研究组患者治疗后的LVEDD为（45.3±3.7）mm,BNP（511.75±89.27）ng/L,分别较对照组显著降低,而研究组患者治疗后的LVEF达（52.1±9.1）%,较对照组显著升高,组间比较,差异具有统计学意义（P〈0.05）。结论卡维地洛可以显著提高慢性心力衰竭的疗效,改善患者的左心功能,降低脑钠肽水平,值得临床推广和应用。
Objective To investigate the effect of earvedilol on left ventrieular function and brain natriuretic peptide levels in patients with chronic heart failure. Methods A total of 64 cases of patients with chronic heart failure treated in our hospital were selected from January 2012 to January 2014, were divided into two groups and patients were given cardiotonic, diuretics, angiotensin converting enzyme inhibitor （ACEI） and other conventional treatment, control group was treated with diuretics and digoxin, ACEI and other conventional anti heart failure treatment, research group with carvedilol. The initial dose was 3.125 mg, 2 times/day, every 2 weeks dose increased 1 times, until it reached the target dose of 25 mg, 2 times/day; if the patient can not reach the target dose to the maximally tolerated dose was load. Course of 6 months. The curative effect, BNP, LVEDD, LVEF changes of two groups were compared before and after treatment. Results after the treatment, the total effective rate of The study group patients was 90.6%, control group was 71.9% af- ter treatment, the efficacy of two groups were compared, the difference was statistically significant （P〈0.05）. The LVEDD, LVEF and BNP after treatment in two groups were significantly improved compared with before treatment （P〈 0.01）, and the after treatment study group LVEDD was（45.3±3.7） mm, BNP was（511.75±89.27）ng/L, respectively, sig- nificantly lower than the control group, while the after treatment, study group in LVEF was （52.1±9.1）%, significantly increased compared with the control group, the difference was statistically significant（P〈0.05）. Conclusion Carvedilol can improve the curative effect of chronic heart failure, improve left ventricular function in patients, reduce the level of brain natriuretic peptide, is worth of clinical promotion and application.
出处
《中国现代医生》
2015年第23期95-97,100,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2010ZHA003)
关键词
慢性心力衰竭
卡维地洛
左心功能
脑钠肽水平
Chronic heart failure
Carvedilol
Left heart function
Brain natriuretic peptide
