目的评估卡维地洛对慢性心力衰竭患者的近期疗效和安全性。方法60例慢性心力衰竭患者随机分为卡维地洛组(C组,n=30)、美托洛尔组(M组,n=30),随访3个月,治疗前和治疗结束时评估心功能分级,用超声心动图测量左室射血分数(LVEF)。并观察两药的耐受性和安全性。结果①治疗后两组心功能均明显改善;总有效率C组为86.7%、M组为80.0%,但两组总有效率比较无显著差异(P>0.05)。②治疗后C组和M组均显著提高LVEF(P<0.0001),卡维地洛组比关托洛尔组增加LVEF更明显(P<0.05)。③治疗后两组血压和心率均明显下降(P<0.05),卡维地洛组血压下降较美托洛尔组明显,两组间有显著差异(P<0.01)。而美托洛尔组心率下降较卡维地洛组明显,两组比较有显著差异(P<0.0001)。④两组药物治疗慢性心力衰竭耐受性良好、安全有效。结论卡维地洛和美托洛尔对慢性心力衰竭的病人均可明显改善心功能,卡维地洛优于美托洛尔。 Objective To evaluate the short-term efficacy and safety of carvedilol in patients with chronic heart failure. Methods Sixty patients with chronic heart failure were randomly divided into carvedilol group (n = 30) and metoprolol group (n = 30). Patients were followed up for 3 months. Before treatment and at the end of treatment, Cardiac function was graded and left ventricular ejection fraction (LVEF) was measured by echocardiography. And observe the two drugs tolerance and safety. Results ① After treatment, the cardiac function of both groups improved significantly. The total effective rate was 86.7% in group C and 80.0% in group M, but there was no significant difference between the two groups in total effective rate (P> 0.05). ② After treatment, LVEF was significantly increased in both C and M groups (P <0.0001). LVEF was more obvious in the carvedilol group than in the Cetolol group (P <0.05). ③ After treatment, blood pressure and heart rate decreased significantly in both groups (P <0.05). The blood pressure in carvedilol group decreased significantly compared with metoprolol group (P <0.01). However, the decrease of heart rate in metoprolol group was more significant than that of carvedilol group (P <0.0001). ④ two groups of drug treatment of chronic heart failure is well tolerated, safe and effective. Conclusion Carvedilol and metoprolol can significantly improve cardiac function in patients with chronic heart failure, and carvedilol is superior to metoprolol.