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目的 观察卡维地洛对扩张型心肌病 (DCM)心衰 (HF)的临床疗效及QT离散度 (QTd)和室性心律失常发生的影响。方法 6 0例DCM并HF患者在利尿剂、洋地黄、转换酶抑制剂 (ACEI)及硝酸盐制剂治疗的基础上 ,随机分为卡维地洛治疗组及常规治疗组 (每组 30例 )。治疗前及治疗 4个月后用超声心动图测左室缩短分数(FS)、射血分数 (EF)、左室舒张末内径 (LVDD)、室间隔厚度 (IVS)和左室后壁厚度 (LVPW ) ,同时检测QTd及室性心律失常。结果 治疗 4个月后 ,两组心功能明显改善。卡维地洛组LVDD[6 1 5± 6 6∶6 7 3± 6 2 ,P <0 0 5 ]、EF[4 8 3± 9 7∶4 0 3± 6 2 ,P <0 0 5 ],D/T[4 1± 0 7∶4 6± 0 5 ,P <0 0 5 ]显著改善 ,QTd显著缩短 ,室性心律失常检出率明显降低。结论 卡维地洛能显著改善DCMHF心功能及心肌重构 ,使QTd缩短而减少室性心律失常的发生。
Objective To observe the effect of carvedilol on the clinical efficacy and QT dispersion (QTd) and ventricular arrhythmia in patients with dilated cardiomyopathy (DCM). Methods Sixty DCM and HF patients were randomly divided into carvedilol treatment group and conventional treatment group (30 cases in each group) on the basis of diuretic, digitalis, ACEI and nitrate preparations. . Before treatment and 4 months after treatment, left ventricular ejection fraction (FS), ejection fraction (LVEF), left ventricular end diastolic diameter (LVDD), interventricular septum thickness (IVS) and left ventricular posterior wall thickness LVPW), simultaneous detection of QTd and ventricular arrhythmias. Results After 4 months of treatment, the cardiac function in both groups improved significantly. LVDD in carvedilol group [6 15 ± 6 6:6 7 3 ± 6 2, P 0 05], EF [483 ± 9 7:4 0 3 ± 6 2, P 0 05] , D / T [4 1 ± 0 7:46 ± 0 5, P <0 0 5] significantly improved, QTd significantly shortened, ventricular arrhythmia detection rate was significantly reduced. Conclusion Carvedilol can significantly improve cardiac function and myocardial remodeling of DCMHF, shortening QTd and reducing the occurrence of ventricular arrhythmia.