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目的探讨国产卡维地洛对慢性充血性心力衰竭患者的临床疗效及安全性。将78例患者随机分为A,B两组,在常规治疗慢性心力衰竭的基础上,A组40例口服卡维地洛(商品名金洛,山东齐鲁制药厂生产),从2.5 mg 2次/d开始,至最大剂量20 mg 2次/d。B组38例口服美托洛尔,从6.25mg每天2次开始,至最大剂量50 mg 2次/d。稳定剂量维持6个月。两组在治疗前及治疗后第3个月和第6个月对所入选患者进行详细体检,并分别行心脏超生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)、心率、血压。服药期间严密观察不良反应并记录。结果与治疗前相比,两组心功能均有明显改善,两组在治疗后3个月和6个月,LVSD、LVDD明显缩小,LVEF明显增加,心率,血压明显下降,而A组较B组更为明显,而不良反应的发生两组无明显差异。结论卡维地洛与美托洛尔均能够使心衰患者的临床症状,心功能得到改善,同时患者的LVSD、LVDD明显缩小,LVEF明显增加。患者的心率及血压明显下降,不良事件发生率低,同时卡维地洛在治疗心衰的同时可以更好地改善患者的运动耐量。
Objective To investigate the clinical efficacy and safety of domestic carvedilol in patients with chronic congestive heart failure. 78 patients were randomly divided into A and B groups. On the basis of routine treatment of chronic heart failure, 40 patients in group A received oral carvedilol (trade name Jinluo, Shandong Qilu Pharmaceutical Factory) from 2.5 mg twice / d start to a maximum dose of 20 mg 2 times / d. In group B, 38 patients received metoprolol orally, starting with 6.25 mg twice daily and up to a maximum dose of 50 mg twice daily. Stable dose for 6 months. The two groups were examined before treatment and at the third month and the sixth month after treatment, and the left ventricular end systolic diameter (LVSD), left ventricular end-diastolic diameter (LVDD) Left ventricular ejection fraction (LVEF), heart rate, blood pressure. Adverse reactions were observed closely during the medication and recorded. Results Compared with those before treatment, both groups had significant improvement in cardiac function. LVSD and LVDD decreased significantly, LVEF increased significantly, heart rate and blood pressure decreased obviously in both groups at 3 months and 6 months after treatment, Group was more obvious, while the incidence of adverse reactions no significant difference between the two groups. Conclusion Both carvedilol and metoprolol can improve the clinical symptoms and cardiac function in patients with heart failure. At the same time, LVSD, LVDD and LVEF in patients with heart failure are significantly reduced. The patient’s heart rate and blood pressure were significantly reduced, the incidence of adverse events is low, while carvedilol in the treatment of heart failure can also improve the patient’s exercise tolerance.