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目的了解心衰患者长期应用卡维地洛对患者心理状况的影响方法:100例慢性充血性心衰(CHF)患者,(男79例,女21例)平均53.23±16.42岁,心功能(NYHA分级)Ⅱ-Ⅳ级,抑郁者39例,焦虑者48例。卡维地洛从小剂量开始,逐渐递增,实验中严密检测各项相关指标。结果:随访98周,随访期间猝死1例,治疗后心功能有明显改善[(2.24±0.79)比(3.05±0.65)P<0.05],6分钟步行距离较治疗前亦有明显进步[(312.71±152.39)比(203.67±134.86)P<0.001],超声心动图示LVEF明显增加[(38.9±6.7)比(32.8±4.9)P<0.001],治疗后反映抑郁状态的SDS评分两组均稍有改善,但无统计学意义,显示焦虑状态的SAS评分均有明显改善,其中焦虑组(n=48)为[(41.57±11.73)比(67.48±16.37)P<0.001]非焦虑组(n=51)[(31.12±9.72)比(36.32±7.84)P<0.001].明尼苏达生活质量量表评分也有显著的改善[(23.86±9.64)比(41.63±13.76)P<0.05]。结论:卡维地洛长期治疗心衰患者除了能明显提高患者的活动耐量,改善心功能外,还能改善CHF患者的焦虑状况,但对抑郁状况无明显影响.
To investigate the effect of long-term use of carvedilol on the psychological status of patients with heart failure.Methods: A total of 100 patients with chronic congestive heart failure (CHF, 79 males and 21 females) were 53.23 ± 16.42 years old, Grade) Ⅱ-Ⅳ level, 39 cases of depression, anxiety in 48 cases. Carvedilol began with small doses, gradually increasing, the test closely test the relevant indicators. Results: During the follow-up period of 98 weeks, one case of sudden death during follow-up showed significant improvement in cardiac function after treatment (2.24 ± 0.79 vs 3.05 ± 0.65, P <0.05) and a 6-minute walk distance ± (38.3 ± 6.7) vs (32.8 ± 4.9), P <0.001]. After treatment, SDS scores reflecting depression status were slightly lower in both groups (N = 48) were (41.57 ± 11.73) vs (67.48 ± 16.37) P <0.001, respectively, in the non-anxiety group (n = 48) = 51) [(31.12 ± 9.72) vs (36.32 ± 7.84) P <0.001]. The Minnesota Quality of Life Scale also significantly improved (23.86 ± 9.64 vs. 41.63 ± 13.76, P <0.05). Conclusion: Long-term treatment of carvedilol in patients with heart failure can significantly improve the patient’s activity tolerance, improve cardiac function, but also improve the anxiety of patients with CHF, but no significant effect on depression.