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目的通过临床试验观察卡维地洛治疗慢性充血性心力衰竭的临床疗效及安全性。方法将75例慢性心衰患者随机分为治疗组(n=38),对照组(n=37),所有患者均接受常规ACEI、利尿剂、地高辛及硝酸酯类药物。治疗组在此基础上加用卡维地洛,从小剂量2.5 mg开始逐渐增加剂量,到最大可耐受剂量后为维持量观察治疗6个月,观察治疗6个月后左室舒张末期容积(LVEDD)、射血分数(LVEF)。结果 6个月治疗后所有患者心功能变化差异有统计学意义(P<0.05),和对照组比较治疗组LVEDD减小(P<0.01),LVEF(%)增加(P<0.01),差异具有统计学意义。结论卡维地洛是兼有α1、β1、β2的全面肾上腺素受体阻断剂,应用小剂量递增疗法可显著改善慢性心衰患者心功能,且安全性高,疗效可靠。
Objective To observe the clinical efficacy and safety of carvedilol in the treatment of chronic congestive heart failure by clinical trials. Methods 75 patients with chronic heart failure were randomly divided into treatment group (n = 38) and control group (n = 37). All patients received routine ACEI, diuretic, digoxin and nitrates. On the basis of this treatment, the treatment group was given carvedilol, and the dose was gradually increased from the low dose of 2.5 mg to the maintenance dose for 6 months after the maximum tolerable dose. The left ventricular end diastolic volume ( LVEDD), ejection fraction (LVEF). Results The changes of cardiac function in all patients after 6 months of treatment were statistically significant (P <0.05). Compared with the control group, LVEDD decreased (P <0.01) and LVEF (%) increased Statistical significance. Conclusion Carvedilol is a full-bodied adrenergic receptor blocker with α1, β1 and β2. The application of small dose escalation therapy can significantly improve cardiac function in patients with chronic heart failure, and its safety and efficacy are reliable.