【摘要】 目的 评价培哚普利在老年慢性心力衰竭(CHF)患者中应用的安全性及疗效。方法 73例老年CHF患 者,男50例,女23例,平均年龄63岁,心功Ⅱ-Ⅳ级,左室射血分数(LVEF)≤45％。从小剂量开始使用培哚普利, 只要能耐受,递增至4-8mg/d,治疗中严密观察监测各项指标。结果 平均随访时间20周,随访期间死亡4例,其 中猝死2例,心力衰竭1例,非心脏原因死亡1例。治疗后心功能较治疗前明显改善[(2.04±0.66)比(3.04± 0.63),P<0.001];6min步行距离也有较明显改善[(330.11±18.32)m比(240.19±16.83),P<0.01];超声心动图 检查示左室舒张末径(LVEDD)和收缩末径(LVESD)减小[(61.07±9.86)mm比(63.76±10.10)mm和(47.20± 11.06)mm比(51.59±10.97)mm,P<0.01];LVEF(％)明显增加[(43.80±10.40)％比(34.79±8.21)％,P< 0.01]。本组患者治疗后血压略有下降,血钾略升高,但均在正常范围,血肌酐无明显变化。结论 应用培哚普利治 疗老年心:力衰竭是安全的,并且能提高老年患者生活质量,改善心功能,增加LVEF。更多还原

【Abstract】 Objective To evaluate the safety and clinical efficacy of Perindopril in treatment of chronic heart failure(CHF)in aged patients. Methods 73 aged patients with CHF(male 50,female 23), mean age being 63 years old and mean EF≤45 % , underwent Perindopril therapy with dosage titrating from Img to 4-8mg per day if they could tolerate. Results During 20 weeks follow-up,4 patients died, among whom 3 dued to cardiac cause. After treatment,NYHA classification and 6-min walk distance were improved significantly[(2. 04±0. 66) vs(3. 04 ±0. 63) P < 0. 001 ]; (330. 11±18. 32) m vs (240.19±16. 83)m,P<0.001. Left ventricular end diastolic diameter(LVEDD)and left ventricular end- systolic diameter(LVESD)measured by echocardiography reduced [(61.15±9.91)mm vs(63.89 ±10.19)mm];(47.20±11. 06)mm vs(51. 49±11.10)mrn,P<0. 01,respectively. Left ventricular eject fraction(LVEF)increased [(43.80±10.40)% vs(34.79±8.12)% ,P<0.001].The blood pressure decreased and serum potassium increased at the end of follow-up, but all in the normal range. Serum creatinine had no significant change. Conclusion The application of Perindopril to treatment of chronic heart failure in aged patient is safe. After treatment, patient’s exercise capability and cardiac function improve and LVEF increases significantly.更多还原