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Carvedilol in the treatment of chronic heart failure
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- Author:
- No author available
- Journal Title:
- CHINA MEDICINE
- Issue:
- 3
- DOI:
- 10.3760/cma.j.issn.1673-4777.2007.03.003
- Key Word:
- 慢性心力衰竭;卡维地洛
Abstract： 目的 研究卡维地洛治疗慢性心力衰竭的疗效及其耐受剂量,用药的安全性.方法 患者87例心功能分级(NYHA)Ⅱ级15例,Ⅲ级61例,Ⅳ级11例;LVEF＜45%.随机分成两组,入选患者病情基本稳定无明显液体潴留,在常规应用血管紧张素转换酶抑制剂、利尿剂、洋地黄基础上,由小剂量开始服用卡维地洛3.125 mg,2次/d.可耐受者每2～4周增加剂量,直至患者的最大耐受量.目标剂量为50 mg/d.随访时间为6～18个月,以核素心肌显像观察左室功能和容积.结果 经过6～18个月的观察和治疗,卡维地洛组临床症状和心功能明显改善,LVEF增加,由(23.31±6.0)%增至(43.53±4.6)%(P=0.0012).左室收缩末期容积由(146.31±30.32)ml减至(69.56±14.27)ml(P=0.0026).左室舒张末期容积减少由(189.97±29.9)ml减至(117.92±19.14)ml(P=0.0037).卡维地洛组有53例(60.9%)耐受目标剂量(50 mg/d),用药中无特殊不良反应.最常见的不良反应是头晕,未出现肝、肾功能损害及血脂、血糖、电解质和血象的变化.结论 在心力衰竭标准治疗基础上应用卡维地洛,可以提高射血分数,缩小扩大的心室腔,改善心功能,改善心室重塑,用药安全、有效.
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