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目的 :探讨美托洛尔与卡维地洛在慢性心力衰竭中的耐受性。方法 :186例慢性心力衰竭患者随机分成美托洛尔组与卡维地洛组 ,在常规抗心力衰竭治疗基础上从小剂量开始逐渐加用美托洛尔与卡维地洛 ,直至目标剂量维持。结果 :美托洛尔组平均维持剂量为 (81.1± 33.5 )mg/d ,坚持维持量者 80例 (84 .2 % ) ,卡维地洛组平均维持剂量为 (34.9± 14 .6 )mg/d ,坚持维持量者 78例 (85 .7% ) ,卡维地洛组较美托洛尔组更易达最大靶剂量 (5 8.2 %∶2 .1% ,P <0 .0 1) ,且剂量调整时间短 [(31.6± 9.4 )d∶(4 6 .7± 17.2 )d ,P <0 .0 1]。美托洛尔组降低心率 (16 .2± 3.5 )次 /min ,卡维地洛组为 (13.8± 4 .1)次 /min(P <0 .0 1)。美托洛尔组降低收缩压 (12 .9± 3.7)mmHg(1mmHg =0 .133kPa) ,舒张压 (6 .7± 2 .6 )mmHg ,卡维地洛组分别为 (14 .4± 4 .1)mmHg和 (7.9± 2 .9)mmHg (P <0 .0 5 )。结论 :慢性心力衰竭患者对美托洛尔和卡维地洛都具有良好的耐受性 ,美托洛尔对心率的影响较大 ,而卡维地洛对血压的影响较大 ,卡维地洛比美托洛尔更易达到最大靶剂量 ,且剂量调整时间短
Objective: To investigate the tolerance of metoprolol and carvedilol in chronic heart failure. Methods: A total of 186 patients with chronic heart failure were randomly divided into metoprolol group and carvedilol group. Metoprolol and carvedilol were gradually added from the low dose on the basis of conventional anti-heart failure treatment until the target dose was maintained . Results: The average maintenance dose of metoprolol group was (81.1 ± 33.5) mg / d, 80 (84.2%) patients sustained maintenance and (34.9 ± 14.6) mg of carvedilol / d, 78 patients (85.7%) persisted in the maintenance volume, the maximum target dose was more accessible to the carvedilol group than the metoprolol group (52.2% vs.2.1%, P <0.01) And the dose adjustment time was short [(31.6 ± 9.4) d: (46.7 ± 17.2) d, P <0.01]. The metoprolol group had a lower heart rate (16.2 ± 3.5) beats / min, and the carvedilol group was (13.8 ± 4.1) beats / min (P <0.01). Metoprolol decreased systolic blood pressure (12.9 ± 3.7) mmHg (1 mmHg = 0.133 kPa) and diastolic blood pressure (6.7 ± 2.6) mmHg, and carvedilol group (14.4 ± 4 .1) mmHg and (7.9 ± 2 .9) mmHg (P <0.05). Conclusion: Patients with chronic heart failure have good tolerance to metoprolol and carvedilol, metoprolol has a greater impact on heart rate, and carvedilol has a greater impact on blood pressure, carvedilol Lobitaloporol is more likely to reach the maximum target dose, and dose adjustment time is short