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1、上海交通大学硕士学位论文卡维地洛治疗慢性心力衰竭患者疗效的影响因素分析姓名：徐怡琼申请学位级别：硕士专业：内科学（心血管病）指导教师：张凤如20070501上海交通大学医学院硕士学位论文心力衰竭再住院与耐受剂量（p=0.001）和NYHA分级（p=0.009）有关。结论：卡维地洛治疗国人CHF的耐受性和疗效均较好，耐受剂量、性别、年龄、NYHA分级、病因、左室射血分数的基线值对卡维地洛的疗效均有影响。卡维地洛治疗后全因死亡、心脏移植术和因HF加重再住院等终点事件亦有显著减少。关键词：慢性心力衰竭，β受体阻滞剂，卡维
2、地洛，疗效，耐受性上海交通大学医学院硕士学位论文THEINFLUENCINGFACTORANALYSISOFTHEEFFECTOFCARVEDILOLINCHINESECHRONICHEARTFAILUREPATIENTSABSTRACTObjective:ToobservethetoleranceandeffectofCarvediloltoChinesechronicheartfailurepatientsandalsoanalysetherelativeinfluentialfacors.Methods:16
3、0stablechronicheartfailurepatientsenrolled,onthebaseofstandardtreatment(Digoxin+ACEI/ARB),theyweregivenCarvedilolandgraduallyuptratetothetargetdoseorthemaximumtolerateddose.DividethepatientsintodifferentgroupstocomparethechangeofNYHAgradeandechocardiographybef
4、oreandafterthetreatmentofCarvedilol.Results:Themeanageofthepatientsis60.00±13.15y.Afterhalf-yearfollow-up,themeandoseofCarvedilolis37.25±14.02mg/d,53.1%ofthepatientsreachthetargetdosage,anotherhalfyearlater,dosegoesto42.27±11.82mg/dandthepercentgoseto63.8%.Aft
5、eracceptingthe上海交通大学医学院硕士学位论文treatmentofcarvedilol,NYHAgrade（p<0.001）,dimensionofLA（p<0.001）,LVDD（p<0.001）,LVSD（p<0.001）andLVEF（p<0.001）ofallthepatientshavesignificantimprovements.Thelargertoleratedosage,male,younger,diastolicmyocardiopathy,NYHAgradeⅡ,lowerbas
6、elineLVEFpatientshavebettereffect.AndBaselineBPandrestingHRdonothingtotheeffectofCarvedilol.Theincidencerateofunionendpointis25.6%,jtisrelativewithtolerancedose(p<0.001)andNYHAgrade(p<0.001);deathrateis5.0%,itisrelativewithtolerancedose(p=0.022)andgender(p=0.0
7、44);rehospitalizationrate20%,itisrelativewithtolerancedose(p=0.001)andNYHAgrade(p=0.009).Conclusions:ChinesechronicheartfailurepatientshaveagoodtoleranceandeffecttoCarvedilol.TheeffectofCarvedilolisrelatedwiththetoleratedosage,gender,age,NYHAgrade,causeandbase
8、lineLVEF.Theunionendpointofallcausedeath,hearttransplantationandrehospitalizationweresignificantlydecreasedafterthetreatmentofCarvedilol.KEYWORDS:chronicheartfailure,beta-blocker,C
