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卡维地洛、倍他乐克治疗小儿扩张型心肌病疗效及安全性比较

发布时间:2018-05-28 16:01

  本文选题:卡维地洛 + 倍他乐克 ; 参考:《重庆医科大学》2012年硕士论文


【摘要】:目的:了解卡维地洛、倍他乐克治疗小儿扩张型心肌病(DCM)的疗效、耐受性及安全性并进行比较。 方法:①收集2006年9月至2011年11月在重庆医科大学附属儿童医院住院治疗的DCM患儿,随机分为卡维地洛治疗组(24例)其中男14例,女10例;平均3.05±3.27岁;倍他乐克治疗组(24例),其中男13例,女11例;平均3.15±2.42岁。两组患儿在性别、年龄及治疗前心功能及心脏大小方面均无统计学差异(P0.05)。②先予强心、利尿等纠正急性心力衰竭,,待心衰控制稳定后,心功能达Ⅱ或Ⅲ级加用β-受体阻滞剂,卡维地洛组患儿以0.1mg/(kg·d)开始口服,倍他乐克组患儿以0.5mg/(kg·d)开始口服。③之后患儿以1次/2周的频率增加药物剂量。④递增到卡维地洛0.8mg/(kg·d)和倍他洛克2mg/(kg·d)后,维持此剂量约12个月。⑤评价两组患儿治疗后心胸比、LVEDV、LVESV、LVEF、LVFS、LVmass、药物安全性及患儿对药物耐受情况并进行比较。 结果:卡维地洛组及倍他乐克组患儿治疗前后比较,治疗后患儿心胸比、LVEDV、LVESV、LVmass均较治疗前明显减少,差异均有统计学意义(P0.05);治疗后患儿LVEF、LVFS升高,差异有统计学意义(P0.05)。治疗前和治疗后卡维地洛组与倍他乐克组患儿比较,心脏大小、收缩功能相当,差异无统计学意义(P0.05);两组患儿达到药物最大耐受剂量的百分比及药物安全性,卡维地洛组稍高于倍他乐克组,但差异无统计学意义(P0.05)。 结论:卡维地洛、倍他乐克都可逆转DCM患儿的心脏的心室重塑,改善心脏功能。两种药物的耐受性均较好,且药物的安全性亦较高。此外,在耐受性及安全性方面,可能卡维地洛较好,具有更好的应用前景,有必要进一步进行多中心、大样本研究以证实。
[Abstract]:Objective: to investigate the efficacy, tolerance and safety of carvedilol and betaloc in the treatment of dilated cardiomyopathy in children. Methods from September 2006 to November 2011, the children with DCM were randomly divided into carvedilol treatment group (n = 24), male (n = 14) and female (n = 10), with an average age of 3.05 卤3.27 years. There were 24 cases of metoprolol in the treatment group, including 13 males and 11 females, with an average age of 3.15 卤2.42 years. There was no significant difference in sex, age, heart function and heart size before treatment between the two groups. P0.05B.2 was given to treat acute heart failure, such as diuretic therapy. After the heart failure was controlled and stabilized, the cardiac function reached grade 鈪

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