【摘要】 目的:观察联合用药治疗老年慢性心衰取得的疗效。方法:老年慢性心衰患者110例,随机分为治疗组和对照组,治疗组56例,对照组54例。两组年龄、性别、心功能及病因构成均无显著性差异(P>0.05)。治疗组用倍他乐克开始为6.25mg2/d,病情稳定后逐步调整到25-50mg/d,每日2次,加螺内酯40mg/d、地高辛0.25mg/d,7天后改为0.125mg/d半月、卡托普利12.5mg,3/d。病情稳定后逐步调整到25mg3/d。对照组:双氢克尿塞25mg2/d,、卡托普利、地高辛用法同治疗组。给药期间患者血压不低于90/60mmHg,心率不低于55次/分;结果:两组病人经治疗6～12月后治疗组较对照组HR、CI、EF、6-MWT有明显改善(p<0.05),两组6～12月后因心衰恶化再住院率有显著差异(p<0.05)。结论:联合用药对老年患者长期治疗可减少住院率,明显提高LVEF和运动耐量,改善患者的生活质量,提高患者的生成率。我们认为倍他乐克、加螺内酯、地高辛、卡托普利联合治疗老年慢性心功能不全安全、有效、副作用小。更多还原

【Abstract】 Objective:Observe the curtive effect of the treatment of senile chronic heart failure by combined use of medicine. Methods: Choose 110 cases of senile chronic heart failure,stochastically divides them into treatment group(56 cases) and comparison group(54 cases).The age, sex, heart function and pathogeny of the two groups are of no remarkable .difference.in treatment group, use Metoprolol, start with 6.25mg 2/d,adjust to 25-50mg/d,when the disease is stabilized,2/d ; added by 40mg/d of Spironolactone, 0.25mg/d of Digoxin,and change into 0.125mg/d for half a month, 12.5mg, 3/d of Captopril 7 days later, adjusting to 25mg 3/d when the disease is stabilized.Comparison group:25mg 2/d of Hydrochlorothiazide,ACE1, the usage of Digoxin is the same with treatment group.During the period of medicine-taken, the patients’ blood pressure should never be lower than 90/60mmHg ,and the heart rate should never be lower than 55 times of / minute. Results: After 6~12 month’ treatment, the HR,CI, EF, 6-MWT of treatment group have obvious improvement compared with comparisongroup(p<0.05).The rate of patients intwo groups who are sent into hospital because of heart failure deterioration after 6~12 months defers greatly(p<0.05). Conclusion:Treating senile patients by combined use of medicine for a long period of time can reduce the number of people who are sent into hospital, obviously enhances LVEF and the movement endurance, improves patient’s life quality, and increases the patient’s production rate.We believe the method of treating senile chronic heart function deficiency by combined use of Metoprolol 、Spironolactone、Digoxin、Captopril is safe, effecive and has few side-effects.更多还原