依那普利联合美托洛尔及螺内酯治疗心力衰竭临床观察

【摘要】 目的:观察血管紧张素转换酶抑制剂依那普利和β-受体阻滞剂美托洛尔联合小剂量螺内酯对慢性心力衰竭(CHF)的远期疗效。方法:共选择CHF患者110例,随机分为对照组(54例)和治疗组(56例)。对照组采用常规治疗(即强心、利尿、扩血管)。治疗组在此基础上加用依那普利5～10mg/日、美托洛尔25100mg/日、螺内酯20mg/日,在治疗前和观察期满5年时分别对心功能NYHAⅡ～Ⅲ级患者做6分钟步行试验,记录步行距离。结果:5年期间,对照组和治疗组因心力衰竭加重再住院率分别为81.48%和28.57% (P<0.05),病死率分别为33.33%和8.92% (P<0.05);与治疗前比较,治疗组心功能(NYHA分级)及6分钟步行距离有明显改善(P<0.05),而对照组无明显改善。结论:依那普利联合美托洛尔及螺内酯可显著改善CHF患者的远期预后。更多还原

【Abstract】 Purpose:Observe long term result of applying angiotensin converting enzyme inhibitor Enalapril and β_receptor blocking agent metoprolol combined with low dose of spiral lactone on chronic heart failure (CHF).Method:chose 110 cases of CHF patients and divided them into comparison group (54 cases) and treatment group (56 cases) at random.The comparison group adopts the conventional treatment (namely cardiotonic,promoting urination,expanding blood vessel).For the treatment group, based on method of the comparison group,En- alapril 5～10mg/d,metoprolol25～100mg/ dspiral lactone 20mg/d are added.Before treatment and end of 5years observation pe- riod,6minutes walking test is adopted for heart function NYHA Ⅱ～Ⅲ level patient to record their walking distance.Result:During the five years,in comparison group and treatment group,the re-hospitalization rates because of aggravation of heart failure are respectively 81.48% and 28.57% (P< 0.05);case fatality rates are respectively 33.33% and 8.92% (P<0.05);comparing to symptom before treatment,heart function(NYHA grade) and 6minutes walking distance of the treatment group is evidently improved (P<0.05);however,the comparison has no evident improvement. Conclusion:The long term prognoses of the CHF patients can be evidently improved by using Enalapril combined with metoprolol and spiral lactone.更多还原