【摘要】 目的探讨奥美沙坦对慢性心力衰竭(chronic heart failure,CHF)的疗效和安全性。方法选取2011年11月至2013年10月在青岛大学医学院附属心血管病医院就诊的CHF患者120例,其中男性50例,女性70例。按随机数字表法分为Ⅰ组和Ⅱ组,每组各60例。两组均给予常规治疗(个体化应用强心剂、利尿剂、醛固酮受体拮抗剂、β受体阻滞剂),Ⅰ组加用奥美沙坦,Ⅱ组加用缬沙坦,连续治疗8周。治疗前及治疗8周后测定两组左心室舒张末内径(LVEDd)、左心室射血分数(LVEF)、N-末端脑钠肽前体(NT-pro BNP)水平、血压以及肾功能等。结果与治疗前比较,Ⅰ组和Ⅱ组治疗后,LVEDd[Ⅰ组:(58.5±6.4)mm vs.(52.2±6.0)mm,Ⅱ组:(58.2±5.9)mm vs.(52.8±5.8)mm]下降,LVEF[Ⅰ组:(39.2±5.2)%vs.(52.1±3.8)%,Ⅱ组:(39.8±6.0)%vs.(50.6±2.7)%]增加,差异具有统计学意义(P均<0.05)。与治疗前比较,Ⅰ组和Ⅱ组治疗后NT-pro BNP[Ⅰ组:(934.0±217.7)pg/ml vs.(184.7±66.6)pg/ml,Ⅱ组:(935.0±224.6)pg/ml vs.(191.6±70.2)pg/ml]明显下降,差异具有显著统计学意义(P均<0.01)。与治疗前比较,Ⅰ组和Ⅱ组治疗后,血压下降,差异具有显著统计学意义(P均<0.01)。结论奥美沙坦能够改善CHF患者心功能,降低NT-pro BNP水平,其疗效不劣于缬沙坦。更多还原

【Abstract】 Objective To discuss the curative effect and safety of olmesartan on chronic heart failure(CHF). Methods The CHF patients(n=120, male 50 and female 70) were chosen from the Cardiovascular Hospital affiliated to Qingdao University Medical College from Nov. 2011 to Oct. 2013. All patients were divided into group Ⅰ and group Ⅱ(each n=60) according to random digits table. All groups were treated with routine therapy(individualized administrations of cardiotonics, diuretics, aldosterone receptor antagonist and β-receptor blockers), and group Ⅰ was additionally given olmesartan, and group Ⅱ, valsartan for 8 w. The changes of LVEDd and LVEF, level of N-terminal pro brain natriuretic peptide(NT-pro BNP), blood pressure(BP) and renal function were detected in 2 groups before and 8 w after treatment. Results After treatment, LVEDd decreased in groupⅠ [(58.5±6.4) mm vs.(52.2±6.0) mm] and group Ⅱ(58.2±5.9) mm vs.(52.8±5.8) mm], and LVEF increased in group Ⅰ [(39.2±5.2)% vs.(52.1±3.8)%] and group Ⅱ [(39.8±6.0)% vs.(50.6±2.7)%, all P<0.05]. After treatment, NTpro BNP decreased significantly in group Ⅰ [(934.0±217.7) pg/ml vs.(184.7±66.6) pg/ml] and group Ⅱ [(935.0±224.6) pg/ml vs.(191.6±70.2) pg/ml, all P<0.05]. After treatment, BP decreased significantly in group Ⅰ and group Ⅱ(all P<0.01). Conclusion Olmesartan can improve heart function and reduce level of NT-pro BNP in CHF patients, and its curative effect is not worse than that of valsartan.更多还原