【摘要】 目的　比较雷米普利 (Ramipril)、强心利尿药联用与强心利尿药单用对慢性心力衰竭 (CHF)患者运动耐量、再住院率及血钾、血肌酐的影响。方法　符合入选条件的CHF患者随机分配至两个组 ,分别接受雷米普利、地戈率、利尿剂 (以下称雷米普利组 )治疗 12周与地戈率、利尿剂(以下称对照组 )治疗 12周。结果　治疗 12周后雷米普利组患者 6min步行距离增加明显 ,与治疗前比较 ,统计学有非常显著差异 (P <0 0 0 1) ;而对照组治疗后 6min步行距离无明显增加 ,雷米普利组再住院率明显低于对照组 ;治疗 12周后 ,雷米普利组血钾明显高于对照组 (P <0 0 1) ,而两组患者血肌酐则无统计学差异。结论　在强心利尿药的基础上加用雷米普利治疗CHF ,可明显提高患者运动耐量及降低再住院率。雷米普利对CHF患者血钾有升高作用 ,对血肌酐影响不明显更多还原

【Abstract】 Objectives To compare the ef fects between Ramipril combined cardiac glycosides, diuretics and only cardiac glycosides, diuretics on exercise test, re hospitalization rate, serum potassium and serum creatinine in patients with chronic heart fai lure. Methods Patients were randomly divided to two groups, one group accepted Ramipril, Digoxin, diure tics (Ramipril group) for 12 weeks; and another group was treated with Digoxin and diuretics (compare group) for 12 weeks. Results After 12 week treatment, 6 minute walk distance increased significantly ( P <0 001) compared with before treatment in Ramipril group while there was no remarkable increase of 6 minute walk distance in compare group. The re hospitalization rate was also lower in Ramipril group than in compare group. The serum potassium level in Ramipril group were remarkably higher than in compare group after 12 week treatment ( P <0 01) while there was no difference on serum creatinine between two groups. Conclusions Based on cardiac glycosides and diuretics treatment, adding Rimipril can significantly increase exercise test score and decrease re hospitalization rate in chronic heart failure patients. Ramipril can increase serum potassium level in CHF patients. There were no remarkable effects observed on serum creatinine level by adding Ramipril treatment in CHF patients.更多还原