关键词 卡维地络；心力衰竭，充血性；6分钟步行试验

    摘要 目的 采用6分钟步行试验，测定卡维地络对充血性心力衰竭的疗效。方法 入选的70例患者左室射血分数≤45%，6min步行距离在150~425m。均行祛除诱因及5~7d的常规治疗(地高辛、血管紧张素转换酶抑制剂、利尿剂)，病情平稳后按入院先后随机分为卡维地洛组35例和对照组35例，卡维地洛组开始加用卡维地洛，起始剂量为2.5mg，2次/d；此后每周剂量增加1倍，直到心率控制在60~65次/min或患者不能耐受或达到40mg/d的目标剂量(仅限于住院期间)。病情稳定后可带药出院继续治疗。治疗前后分别行6分钟步行试验，并与临床症状的改善及彩色多普勒检测结果进行对照。结果 发现卡维地络组心功能明显好转，总有效率94%，心率、血压降低(P<0.05或P<0.01)，LVESD、LVEDD、心胸比明显减小，LVEF增加(P<0.01)，6min步行距离增加(P<0.01)，与对照组相比,卡维地络改善更明显(P<0.01)。结论 卡维地络更能有效地改善心功能，提高运动耐量。

    EFFECT OF CARCEDIOL ON PATIENTS WITH CONGESTIVE HEART FAILURE BY 6 MINUTES WALK REST

    Li Xiangfen,Liu Xinqun.

    The Nanyang Second People's Hospital, Nanyan 473012,China

    Key words carvediol; heart failure; congestive; 6 minutes walk test

    Abstract Objective To evaluate the clinical effect of carvediol on patients with congestive heart failure(CHF) by 6 minutes walk test(6MWT). Methods All the subjects were patients with left ventricular ejection fraction (LVEF)≤45%,and the 6-minute walking distance between 150 and 425 meters, who were treated with digoxin, angiolensin-converting enzyme inhibitors and diuretic. They were randomly divided into carvediol group (35 cases, 20 males and 15 females) and control group(35 cases, 22 males and 13 females )after states of illness were stable. The carvediol group treated with carvediol at the beginning, the initial dosage was 2.5mg, Bid; Hereafter, the dosage increased every week until heart rate was controlled in 60～65 per minute, or the patients couldn't endure, or achieved 40mg/d desired dosage(only restricted in hospital).After the conditions were stable, they could be home to take medicine continuely. The 6 MWT was done in pretreatment and post treatment respectively and compared it with dinical symptom and Doppler results. Results Carvediol could remarkably improve heart function and the total efficiency was 94%.The heart rate ,blood pressure decreased (P<0.05 or P<0.01),LVESD,LVEDD,CHT also reduced obviously while LVEF and the 6minute walking distance improved(P<0.01).Compared with control group, the heart function in the Carvediol group improved significantly (P<0.01). Conclusion Carvediol may effectively improve the heart function and exercise tolerance than other medicines. ......