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目的:评价卡维地洛在心、肾联合损害治疗中的耐受性和安全性。方法:选择慢性心力衰竭(CHF)合并慢性肾功能不全(CRF)患者68例,在常规抗心衰治疗的基础,包括应用洋地黄、血管紧张素转化酶(ACE)抑制药、利尿剂上,加用第三代β受体阻滞剂卡维地洛,最大剂量37.5mg/d,疗程6个月。观察卡维地洛治疗的耐受性和不良反应。结果:卡维地洛改善CHF+CRF患者心输出量和肾小球滤过功能,药物耐受性好,68例患者全部完成6个月治疗,其中22例达最大设定剂量37.5mg/d,平均剂量为25.2mg/d。药物不良反应共发生为19例,其中需要紧急处理的严重不良反应4例,均为可逆性。结论:第三代β受体阻滞剂卡维地洛在改善心肾联合损害患者的心、肾功能同时,耐受性好,不良反应发生率低。
OBJECTIVE: To evaluate the tolerability and safety of carvedilol in the treatment of heart and kidney damage. METHODS: Sixty-eight patients with chronic heart failure (CHF) and chronic renal insufficiency (CRF) were enrolled in this study. They were used in the treatment of conventional anti-heart failure, including digitalis, angiotensin converting enzyme (ACE) Add third-generation beta-blocker carvedilol, the maximum dose of 37.5mg / d, treatment for 6 months. Observe carvedilol treatment tolerance and adverse reactions. Results: Carvedilol improved cardiac output and glomerular filtration rate in patients with CHF + CRF. The drug tolerance was good. 68 patients completed 6 months of treatment, of which 22 patients reached the maximum set dose of 37.5mg / d , The average dose of 25.2mg / d. A total of 19 cases of adverse drug reactions, including the need for urgent treatment of serious adverse reactions in 4 cases, are reversible. CONCLUSION: Carvedilol, the third-generation β-blocker, is well tolerated and has a low incidence of adverse reactions in improving cardiac and renal function in patients with cardio-renal impairment.