摘要
目的探讨依那普利,伊贝沙坦及两者联合用药对慢性心力衰竭左室重构的干预作用。方法慢性心力衰竭74例随机分成依那普利组(5-10mg/d,25例),伊贝沙坦组(37.5～75mg/d,22例),联合用药组(依5～10mg/d,伊37.5～75mg/d,27例)。2周后如血压能耐受增加药物剂量(血压≥90/60mmHg,1mmHg=0.133kpa,反之,则不增加剂量),即依那普利及伊贝沙坦分别增加到20mg/d和150mg/d,总疗程共12月,治疗前后用彩色多普勒检测左室相关数据,放射免疫法测定血浆肾素活性(Ren),血管紧张素Ⅱ(AT—Ⅱ),醛固酮(Ald)水平。结果①依那普利组及伊贝沙坦组治疗前后比较,室间隔厚度(1VSD),左室后壁(PWT1),左心室重量指数(LVM1)均显著下降(P<0.05),左心室射血分数(LVEF)显著改善(P<0.05)。联合用药组治疗前后比较,除IVSD显著下降(P<0.05)外,PWTD、LVMI下降更显著(P<0.01),LVEF改善更显著(P<0.01)。②比较3组治疗前后Ren,AT-Ⅱ,及Ald水平,依那普利组能显著降低AT-Ⅱ及Ald水平(P<0.05),同时非常显著升高Ren水平(P<0.01),伊贝沙坦组能显著降低Ald水平(P<0.05),但对Ren及AT-Ⅱ水平影响无显著差异(P>0.05),联合用药组能非常显著地降低AT-Ⅱ及Ald水平(P<0.01),升高Ren水平(P<0.01)。结论依那普利与伊贝沙坦的联合应用比各自单一应用能更显著地逆转老年慢性心力衰竭左室重构,改善LVEF,抑制AT-Ⅱ及Ald的产生。
Objective Probe into the intervenient action of Enalapril Irbesrtan and the anion of the two on LVR of CHF. Methods random divide CHF 74 cases into （5-10mg/d 25 cases）. Irbesrtan （37.5-75mg/d, 22 cases）, and the union （Enalapril 5-10mg/d, Irbesrtan 37.5-75mg/d, 27cases）Two weeks later add the dose if the blood pressure can bear （Bp≥90/60mmHg,1mmHg=0.33kpa, conversely not）, that is increase Irbesrtan and Enalapirl separately to 20mg/d and 150 mg/d. The total course of treatment is 12 months. Examine the left vantrieular revelant date by color Doppler before and after treafment. Determine plasma Ren, AT-Ⅱ and Aid by radionimmunoassay. Results ①Through the comparison of Enalpapril and Irbesrtan before and after treatment, IVSD, PWTD and LVMI all prominendy drop （P〈0.05）, and improve LVEF（P〈0.05）, Through the comparison of the union before and after treatoment, IVSD prominendy drops （P〈0.05）, PWTD and LVWI drop mere prominendy（P〈0.01） and improve, LVEF （P〈0.01）. ②Through the comparison of Ren, AT-Ⅱ and Aid before and after treatment, Enalapfil can promimently drop AT-Ⅱ and Aid （P〈0.05）, at the same time, raise Ren （P〈0.01）. Irbesntan can prominently drop Aid（P〈0.05）, but has no remarkable effect on Ran and AT-Ⅱ （P〉0.05）, The Union of the two can prominently drop AT-Ⅱ and AId（P〈0.01） and raise Ren （P〈0.01）. Condusions The combined use of Enalapril and Irbes can can more prominently reverse, LVR of ACHF, improvere LVEF and restrain the formations of AT-Ⅱ and ALD）.
出处
《海南医学》
CAS
2005年第12期47-48,共2页
Hainan Medical Journal
