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目的:分析卡维地洛治疗小儿扩张型心肌病(DCM)的机制及安全性,探讨改善DCM患儿心功能的方法。方法:将92例DCM患儿随机分为观察组和对照组各46例,对照组给予美托洛尔治疗,观察组给予卡维地洛治疗,持续治疗6个月,治疗前后测量患儿血清N末端脑利钠肽前体(NT-pro BNP)、超氧化物歧化酶(SOD)、丙二醛(MDA)变化。结果:治疗后观察组NT-pro BNP、MDA浓度低于对照组(P<0.05),左心室射血分数(LVEF)、SOD活性高于对照组(P<0.05)。观察组达药物最大剂量耐受率为88.64%,高于对照组的72.09%(P<0.05)。结论:卡维地洛治疗小儿DCM耐受性良好,无严重不良反应,可逆转患儿心室重塑,其机制可能与降低心肌氧化应激有关。
Objective: To analyze the mechanism and safety of carvedilol in treating children with dilated cardiomyopathy (DCM) and to explore ways to improve cardiac function in children with DCM. Methods: Ninety-two children with DCM were randomly divided into observation group (46 cases) and control group (46 cases). The control group was treated with metoprolol. The observation group was given carvedilol treatment for 6 months. Before and after treatment, N-terminal pro-brain natriuretic peptide (NT-pro BNP), superoxide dismutase (SOD) and malondialdehyde (MDA) Results: After treatment, the levels of NT-pro BNP and MDA in the observation group were lower than those in the control group (P <0.05). The left ventricular ejection fraction (LVEF) and SOD activity were higher in the observation group than those in the control group (P <0.05). The maximum dose tolerated rate of the observed group was 88.64%, which was higher than that of the control group (72.09%, P <0.05). Conclusion: The carvedilol treatment of children with DCM well tolerated, no serious adverse reactions can be reversed ventricular remodeling in children, the mechanism may be related to reducing myocardial oxidative stress.