卡维地洛对缺血性心脏病患者心肌收缩力影响.docVIP

卡维地洛对缺血性心脏病患者心肌收缩力影响 　　[摘要] 目的 研究卡维地洛对缺血性心脏病心肌收缩力及预后的临床疗效。方法 选取缺血性心脏病CHF 64例，随机分为倍他乐克组（A组，32例）和卡维地洛组（B组，32例），A组和B组在常规药物治疗、病情稳定基础上分别加用倍他乐克和卡维地洛，调整剂量稳定，随访3个月后回医院检测各项指标。结果 卡维地洛组和倍他乐克组均能有效降低心率，降低血压，减少左心室LVEDD、LVESD，但前者的LVESD较后者低（P＜0.05），Dd值较后者高（P＜0.05）。倍他乐克组可以明显地减少CO和CI，而卡维地洛组CO和CI变化不明显，两组比较差异有统计学意义（P＜0.05）。两者均可提高每搏输出量和LVEF值，但与治疗后倍他乐克组比较，卡维地洛组有较高的每搏输出量（P＜0.05）和LVEF值（P＜0.01）。结论 卡维地洛比倍他乐克的临床疗效好，是一种安全、有效的CHF新药。 　　[关键词] 缺血性心脏病??心肌收缩力；卡维地洛 　　[中图分类号] R541.4 [文献标识码] B [文章编号] 1673-9701（2011）23-88-02 　　 　　Clinnical Effects of Carvedilol on Cardiac Contractility with Ischemic Heart Disease 　　ZHAO Feimin ZHANG Chuan SHEN Jiaying 　　The Central Hospital of Huzhou City in Zhejiang Province，Huzhou 313000，China 　　 　　[Abstract] Objective To explore the effects and safety of Carvedilol on cardiac contractility in ischemic heart disease with the chronic congestive heart failure （CHF）．Methods Sixty-four patients with CHF were randomly divided into 2 groups：the Betaloc group（A group，32cases）and the Carvedilol group（B group，32 cases）. The A group was treated by Betaloc，while B group by Carvedilol base on the basic treatment. Follow-up for 3 mongths and detect the index. Results Both the two groups could reduce heart rate，blood pressure，left ventricle’s LVEDD and LVESD，but the B group had the lower LVESD and higher Dd value than the A group （P＜0.05）. CO and CI value of group A was reduced，there was significant difference between two groups（P＜0.05）. Group B had the higher SV（P＜0.05）and LVEF（P＜0.01）than that in group A. Conclusion Carvedilol is more effective than Betaloc. It is a effective and safty treatment to chronic congestive heart failure. 　　[Key words] Ischemic heart disease；Cardiac contractility；Carvedilol 　　 　　缺血性心肌病（ischemic heart disease，ICM）是指冠状动脉病变引起心肌缺血、坏死，心肌局限性、弥漫性纤维化或硬化，导致心肌肥大和心功能衰竭的一种临床综合征，常因反复发生心衰和心律失常而猝死。卡维地洛为第三代β受体阻滞剂，能够同时阻滞β1、β2受体和α1受体，大规模临床试验[1]表明，卡维地洛能显著改善心衰患者的左室功能，提高LVEF值，降低心衰病死率。近年发现其能改善心衰患者的预后，但是卡维地洛治疗缺血性心脏病心肌收缩力的疗效临床报道甚少。本文观察新型β受体阻滞卡维地洛治疗缺血性心脏病慢性心功能衰竭（ch