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Title:: Carvedilol in treatment of patients with chronic heart failure and chronic renal failure

作者:: 钱正明; 黄建振; 彭俊; 杭州市萧山区第一人民医院心内科，浙江杭州 311201

Author(s):: QIAN Zhengming; HUANG Jianzhen; PENG Jun; Department of Cardiology, Hangzhou Xiaoshan NO.1 People’s Hospital, Hangzhou 311201, Zhejiang, China

关键词:: 卡维地洛; 心力衰竭; 慢性肾功能; 疗效

Keywords:: carvedilol; heart failure; chronic renal function; treatment

分类号:: R541.6

DOI:: -

文献标识码:: A

摘要:: 目的观察在常规治疗基础上应用卡维地洛对慢性心力衰竭（CHF）并发肾功能不全患者的临床疗效。方法采用自身对照的方法，27例CHF并发肾功能不全的患者在接受常规治疗的基础上加用卡维地洛直到目标剂量，比较治疗前及治疗12周后患者的心功能和肾功能。结果治疗12周后患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)较治疗前明显缩小(P<001)，左室射血分数(LVEF)较治疗前显著增高(P<001)。治疗12周后血尿素氮(BUN)、肌酐(Cr)、β2微球蛋白(β2MG)较治疗前明显降低(P<001)。结论在常规治疗基础上应用卡维地洛能明显改善CHF并发肾功能不全患者的心功能和肾功能。

Abstract:: AIM To investigate the clinical effect of carvedilol for patients with chronic heart failure and chronic renal failure. METHODS In addition to regular treatment of digoxin, diuretics and angiotensinconverting enzyme inhibitor, 27 patients were treated with carvedilol gradually to target dosage for 12 weeks. We compared the cadiac function and the renal function before and after the treatment of carvedilol. RESULTS After treatment for 12 weeks, the left ventricular enddiastolic dimension (LVEDD) and left ventricular endsystolic dimension (LVESD) reduced significantly, while the left ventricular ejection fraction (LVEF) increased significantly. The blood urea nitrogen (BUN), serum creatinine (Cr) and blood β2microglobulin (β2MG) decreased significantly. CONCLUSION Carvedilol improves the cadiac function and the renal function of patients with chronic heart failure and chronic renal failure.

参考文献/References

［1］ PooleWilson PA, Swedberg K, Cleland JG, et al. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial［J］. Lancet, 2003, 362(9377):7-13.

［2］ Frantz RP, Olson LJ, Grill D, et al. Carvedilol therapy is associated with a sustained decline in brain natriuretic peptide levels in patients with congestive heart failure［J］. Am Heart J, 2005, 149(3):541-547.

［3］ Hart PD, Bakris GL. Should betablockers be used to control hypertension in people with chronic kidney disease?［J］. Semin Nephrol, 2007, 27(5):555-564.

［4］ Horani MH, Haas MJ, Mooradian AD. Suppression of Hyperglycemiainduced superoxide formation and endothelin1 gene expression by carvedilol［J］. Am J Ther, 2006, 13(1):2-7.

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在常规治疗基础上应用卡维地洛治疗慢性心力衰竭并发肾功能不全患者的效果(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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