Study on clinical curative effect of carvedilol in the treatment of children with chronic congestive heart failure

doi:10.3969/j.issn.1674-3806.2015.03.09

Abstract：Objective To observe the curative effect and target dose and the safety of carvedilol in the treat-ment of children with chronic congestive heart failure ( CHF) .Methods Ninety children with CHF were randomly di-vided into 3 groups:ordinary regimen group ( n =30 ) , metoprolol regimen group ( n =28 ) and carvedilol regimen group(n=32).The three groups were treated with routine therapy (diuretic, ACEI or digitalis), treatment groups were treated with carvedilol or metoprolol in addition to routine therapy .The serum levels of BNP were measured by enzyme-linked immune absorbent assay .The heart rate ,cardiothoracal ratio ( CTR) , left ventricular end diastol diam-eter (LVEDD), left ventricular end systolic diameter (LVESD) and the left ventricular ejection fraction (LVEF) were measured by X-ray and echocardiogram before and 6 months after treatment.Results (1)After treatment, the clini-cal symptoms were significantly improved , CTR, heart rate, cardiac function grades decreased , and ejection fraction ( EF) was significantly increased showing carvedilol group was superior to metoprolol group ( P <0.01 ) .( 2 ) The LVEDD and LVESD were notably decreased after treatment with carvedilol .There were significant difference .Com-pared with metoprolol group , there was a great significant difference ( P<0.05 ) .( 3 ) Plasma concentration of BNP was significantly decreased , carvedilol was more effective than the other two groups ( P <0.01 ) .Conclusion Carve-dilol can prevent and reverse the neurohumoral disorders in chronic heart failure and can improve the cardiac function of children with CHF .Carvedilol is effective and safe in the treatment of children with CHF and superior to metoprolol .