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1、卡維地洛治療老年慢性心力衰竭的臨床療效觀察【摘要】目的:觀察卡維地洛治療老年慢性充血心力衰竭(CHF)的臨床療效及副作用。方法:72例老年CHF患者隨機(jī)分為卡維地洛組(治療組)和常規(guī)治療組(對(duì)照組),各36例。對(duì)照創(chuàng)使用洋地黃、利尿劑、血管緊張素轉(zhuǎn)換酚抑制劑、硝酸酯類等藥物治療。治療組在常規(guī)治療的基礎(chǔ)上加用卡維地洛5mg/d,只要能耐受盡可能遞增到10~20mg/d,療程20周。每周測(cè)量血壓、心率,評(píng)定心功能,治療前后檢查超聲心動(dòng)圖。結(jié)果:治療紐.左室射血分?jǐn)?shù)(LVEF)明顯升高(PvO001),丿渤能分級(jí)、左室舒張末期內(nèi)徑(EV
2、EDD)、心肌耗氧指數(shù)和收縮末期內(nèi)徑(LVESD)明顯降低(PvO01),心率減慢,血壓降低(PvO01),與對(duì)照紐比較差異有顯著性(PvO05)o結(jié)論:卡維地洛治療心力衰竭改善心功能,改善左室重塑,安全有效?!娟P(guān)鍵詞】心力衰竭充血性卡維地洛老年人Efficacyofcarvedilolintreatmentofchronicheartfailure/GUOLi,ZHANGLi,QUHonglyu,GAOShan//ChineseJournalofCardiovascularRehabilitationMedicine,2007,
3、16(1):65Abstract:Objective:Toevaluatetheefficacyofcaivedilolintreatmentofchronicheartfailure(CHF).Methods:Atotalof72patientswithCHFwererandomlydividedintocarvedilolgroup(36cases)andcontrolgroup(36cases)Twogroupsweretreatedwiththeroutinemedicine,includingdigitalis,diur
4、etics,ACEIandnitratesCarvedilolwasaddedtocarvedilolgroupCarvedilolbeganfrom5mgperdayandwasgraduallyincreasedto10?20mgperdayiftheyweretoleratedThetreatmentwaslastedfor20weeksTheheartfunctionwasevaluatedandheartrates,andbloodpressureweremeasuredonceaweek.TheLVEF^LVEDDan
5、dLVESDwereevaluatedbyechocardiographybeforeandafterthetreatment.Results:Aftertreatment,theLVEFsignificantlyincreased(P<0001).However,theheartfunctiongrade,LVEDD,LVESD,bloodpressureandheartratesdecreased(P<001)incarvedilolgroupTheaboveindexesofcarvedilolgroupimprovedmo
6、rethanthoseofcontrolgroup(P<005all).Conclusion:Carvediloliseffectiveandsateintreatingchroniccongestiveheartfailure,whichcanimproveobviouslytheremodelingofleftventricle.Author′saddress:DepartmentofGerontology,theFirstAffiliatedHospitaljiamusiUniversity,Jiamusi,He
7、ilongjiang,154002,ChinaKeywords:Heartfailure,congestive;Carvedilol;Theaged卡維地洛是一種無(wú)內(nèi)在擬交感活性的非選擇的第三代&be(a;-受體阻滯劑,同時(shí)具有α受體的阻滯作用,并II是一種強(qiáng)效自山基清除劑,有抗氧化,抗増生及抑制細(xì)胞凋亡等功能[1]。卡維地洛己在一些大規(guī)模的臨床實(shí)驗(yàn)中用于慢性心力衰竭(CHF)的治療[2],本研究旨在觀察卡維地洛治療老年心力衰竭的臨床療效及安全性。1資料與方法11—般資料研究對(duì)象為2003年5月~2005年8月我院門診
8、及住院CHF秋,共72例,按照美國(guó)紐約心臟病學(xué)會(huì)(NYHA)1979年制定的CHF診斷標(biāo)準(zhǔn)及心功能分級(jí),為NYHAII-IV級(jí)患者,隨機(jī)分為治療組、對(duì)照紐?,各36例,其屮冠心病45例,風(fēng)心病7例,擴(kuò)張性心肌病13例,高血圧心肌病7例。排除:Il&