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卡维地洛治疗扩张型心肌病复杂型室性心律失常的疗效评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第2期
页码:
121-123
栏目:
临床研究
出版日期:
2003-03-01

文章信息/Info

Title:
Efficacy of carvedilol in the treatment of complex ventricular arrhythmias in dilated cardiomyopath
作者:
曾佑平; 张利华
第四军医大学唐都医院心脏内科,陕西 西安 710038
Author(s):
ZENGYou-ping; ZHANGLi-hu
Departmentof Cardiology,Tang du Hospital,Fourth Military Medical University,Xi'an, Shaan xi 710038,Chin
关键词:
心肌病; 扩张型; 心力衰竭; 卡维地洛; 心律失常; 室性; 复杂型非持续性
Keywords:
cardiomyopathy;  dilated;  heartfailure;  Carvedilol;  arrhythmias;  ventricular;  complexnon-sustained
分类号:
R541.7;R972.2
DOI:
-
文献标识码:
A
摘要:
目的:探讨卡维地洛治疗扩张型心肌病复杂型非持续性室性心律失常的临床疗效。方法:将104例缺血性或 特发性扩张型心肌病复杂型心律失常患者随机分成两组:卡维地洛组54例,对照组50例,两组均常规强心、利尿 及血管紧张素转换酶抑制剂类药物治疗,仅卡维地洛组加用卡维地洛口服治疗;疗程6月。采用24h动态心电图和 多普勒超声心动图,观测治疗前后的HR、室性早搏(PVC)、非持续性室性心动过速(NSVT)、左心室射血分数 (LVEF)。结果:经卡维地洛治疗1月后,卡维地洛组较对照组抗心律失常作用增加明显,有显著性差异(P<0.05); 3月后,卡维地洛组较对照组LVEF明显增加(P<0.05),抗心律失常作用在卡维地洛组进一步增加,而HR、血压 无明显变化(P>0.05)。结论:在传统抗心衰药物治疗的基础上长期加用卡维地洛,对治疗扩张型心肌病复杂型室 性心律失常具有明显疗效。
Abstract:
AIM:To evaluate the clinical effect of complex ventricular arrhythmias in dilated cardiomyopathy (DCM) treated with Carvedilol. METHODS: 104 patients with complex ventricular arrhythmias in ischaemic or idiopathic dilated cardiomyopathy were randomly allocated to two groups. In the carvedilol group(n=54) patients were treated with carvedilol coupled with commonly used drugs of cardic glycoside,diuresis and angiotensin-converting enzyme inhibitor(ACEI);in the control group(n=50) patients were treated only with commonly used cardiac glycoside,diuresis and ACEI medicine. The course of treatment was 6 months. Before and after the treatment, 24 hour Holter was used to monitor HR, PVC and NSVT, and Doppler ultrasound cardiogram was used to measure left ventricular ejection fraction(LVEF). RESULTS:After 1 month's treatment, the antiarrhythmic efficacy of the carvedilol group was significantly higher than that of the control group(P<0.05); After 3 month's treatment, LVEF was significantly improved in the carvedilo lgroup compared with that in the control group(P<0.05),and compared with that after 1 month's treatment, the antiarrhythmic efficacy was further enhanced in the carvedilol group, butthere was no significantly difference between the two groups in the HR and the pressure(P> 0.05). CONCLUSIONS: Carvedilol coupled with commonly used cardiac glycoside,diuresis and ACEI medicine has a better curative effect in treating complex ventricular arrhythmias in dilated cardiomyopathy.

参考文献/References

[1]张志寿.心肌病的诊断与治疗[M].北京:人民军医出版社,2001.13-34.

[2]吕钰,李建华,高希春.当代心脏病学[M].北京:华文出版社,2001.498-499.

[3] Cice G,Tagliamonte E,FerraraL,et al.Efficacy of Carvedilol on complex ventricular tachycardias in dilated cardiomyopathy:double-blind,randomized,placebo-controlled study[J].Eur HeartJ,2000,21(15):1259-1264.

[4] Skudicky D,Bergemann A,Sliwa K,et al.Beneficial effects of pentoxifylline in patients with idiopathic dilated cardiomyopathy treatedwith angiotensin-converting enzyme inhibitors and carvedilol : results of a randomized study [J]. Circulation,2001,103(8):1083-1088.

[5]Gerson IC,Craft LL,IcGuire N,et al.Carvedilol improves left ventricular function in heart failure patients with idiopathic dilated cardiomyopathy and a wide range of sympathetic nervous system function as measured by iodine 123 metaiodobenzylguanidine[J].J Nucl Cardiol,2002,9(6):608-615.

备注/Memo

备注/Memo:
收稿日期：2002-11-28.
更新日期/Last Update: 2003-03-01