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目的探讨卡维地洛与美托洛尔对慢性心力衰竭患者的疗效差异。方法将149例慢性心力衰竭(CHF)患者,心功能NYHA分级Ⅱ~Ⅲ级,在应用洋地黄、利尿剂、血管紧张素转换酶抑制剂(ACE-I)等常规治疗基础上,随机分为卡维地洛组(74例),美托洛尔组(75例),观察时间12个月。治疗前和治疗结束时行超声心动图检查,测定左室收缩末期内径(LVSD)、左室舒张末期内径(LVDD)、左室射血分数(LVEF)、室间隔厚度(IVS)、左室后壁厚度(LVP)、E/A比值、心胸比;测量治疗前后6 min步行距离;血压(BP)、心率(HR)变化。结果卡维地洛组患者心率变慢、左室舒张末径减少、LVEF增加、E/A比值提高、左室厚度减少、心胸比减少与美托洛尔组差异有统计学意义。结论卡维地洛和美托洛尔治疗CHF患者1年后,卡维地洛在阻断交感神经的过度激活,抑制或逆转心室重构、改善心功能、提高CHF患者生存质量方面优于美托洛尔。
Objective To investigate the difference of therapeutic effect between carvedilol and metoprolol in patients with chronic heart failure. Methods One hundred and ninety-nine patients with chronic heart failure (CHF) were divided into three groups: NYHA class Ⅱ ~ Ⅲ, and divided into the following groups randomly according to routine treatment: digitalis, diuretic, angiotensin converting enzyme inhibitor (ACE- Carvedilol group (74 cases), metoprolol group (75 cases), observation time was 12 months. Before treatment and at the end of treatment, echocardiography was performed to measure left ventricular end systolic diameter (LVSD), left ventricular end diastolic diameter (LVDD), left ventricular ejection fraction (LVEF), interventricular septum thickness (IVS) Wall thickness (LVP), E / A ratio and cardiothoracic ratio. The walking distance, blood pressure (BP) and heart rate (HR) were measured at 6 min before and after treatment. Results The carvedilol group had slower heart rate, decreased left ventricular end-diastolic diameter, increased LVEF, increased E / A ratio, decreased left ventricular thickness, and decreased cardiothoracic ratio compared with metoprolol group. Conclusion Carvedilol and metoprolol treatment of CHF patients in 1 year, carvedilol in the block of sympathetic over-activation, inhibition or reverse ventricular remodeling, improve cardiac function, improve quality of life in patients with CHF better than the United States care Lol.