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目的 探讨卡维地洛对缺血性心脏病心力衰竭患者心室重塑及心功能的影响。方法 缺血性心脏病心力衰竭患者 80例 ,左室射血分数≤ 4 5 %,心功能 (NYHA)Ⅱ～Ⅳ级 ,常规治疗基础上随机分为治疗组和对照组。治疗 6个月 ,观察卡维地洛对心室重塑和心功能的影响。应用心脏彩色超声仪测定基线值及1、3、6个月左室结构及功能指标变化。结果 卡维地洛平均用量为 (15± 3.75 )mg/d ,经过 6个月治疗卡维地洛组心功能改善 ,与对照组比较左室射血分数上升 [(4 8.1± 2 .5 ) %与 (39.5± 2 .74 ) %,(P =0 .0 0 2 ) ],左室收缩末容积下降 [(16 3.5 0± 4 5 .0 0 )ml与 (181.10± 4 4 .0 0 )ml,(P =0 .0 4 2 ) ];与基线比较左室舒张末容积下降 (P<0 .0 5 ) ;但两组间尚无统计学差异。结论 在利尿、血管紧张素转换酶抑制剂基础上 ,应用卡维地洛能显著改善缺血性心脏病心力衰竭患者的心功能 ,改善心室重塑。
Objective To investigate the effect of carvedilol on ventricular remodeling and cardiac function in patients with heart failure due to ischemic heart disease. Methods Eighty patients with heart failure with ischemic heart disease, left ventricular ejection fraction ≤ 45% and NYHA Ⅱ ~ Ⅳ were randomly divided into treatment group and control group. After 6 months of treatment, the effects of carvedilol on ventricular remodeling and cardiac function were observed. The baseline value and the change of left ventricular structure and function index at 1, 3, and 6 months were measured by colorimetric system. Results The average amount of carvedilol was (15 ± 3.75) mg / d, after 6 months of treatment, the improvement of cardiac function in the carvedilol group was observed. Compared with the control group, the left ventricular ejection fraction increased [(4 8.1 ± 2.5) % And (39.5 ± 2.74)%, (P = 0.002)], the left ventricular end-systolic volume decreased [(16 3.5 ± 0.4 5 0 0) ml and (181.10 ± 4 4 0 0 ) (P = 0.042)]. Compared with baseline, the left ventricular end-diastolic volume decreased (P <0.05), but there was no significant difference between the two groups. Conclusion On the basis of diuretic and angiotensin converting enzyme inhibitors, carvedilol can significantly improve cardiac function and improve ventricular remodeling in patients with heart failure of ischemic heart disease.