依那普利和卡维地洛治疗充血性心力衰竭60例临床观察

Clinical analysis of Enalapril combined with Carvedilol treatment in 60 patients with congestive heart failure

目的观察依那普利(依苏)和卡维地洛(络德)治疗充血性心力衰竭的临床疗效并探讨其作用机制。方法将120例CHF患者随机分为治疗组(60例)和对照组(60例),在传统的强心、利尿、扩血管药物等措施治疗使心功能稳定的基础上,对照组即给予依那普利5mgqdpo;治疗组则在对照组治疗的基础上给予卡维地洛3.125mgbidpo开始,2周后剂量上调为5mgbidpo,以后每2周上调1次,直至最大耐受剂量或至推荐靶剂量25mgbidpo。分别于3个月后进行随访。结果在3个月～2年的随访期间,治疗组总有效率86.67%;对照组总有效率58.33%。有显著性差异(P<0.01)。治疗组在改善心功能参数方面显著优于对照组(P<0.05～0.01)。治疗组因心衰加重而再住院率和死亡率均低于对照组(P<0.05)。未见明显毒副作用。结论在强心、利尿、扩血管和ACEI等治疗的基础上,在充血性心力衰竭患者的病情稳定后,加用卡维地洛(络德)可提高运动耐量,降低其再住院率和死亡率。

Objective To observe the clinical features of patients with congestive heart failure(CHF) and explore the mechanism of Enalapril combined with Carvedilol to treat CHF. Methods 120 patients with CHF were randomized to treatment group and control group, Enalapril(5mg qd po ) was given on the traditional therapy (i.e. Cardiotonic agents;Cardiad diuretic agents;Vasodilator and so on) in control group, Carvedilol was added on basic therapy in control group patients from 3.125mg bid po, and up-titrated in an interal of 2 weeks till target dosage of 25mg bid or maximal tolerance.Results After treatment with Enalapril combined with Carvedilol,the heart function was improved significantly. The total response rate was 86.67% for treatment group and 58.33% for control group(P<0.01=. During follow-up(3mo～2a), the rates of recurrent CHF ,readmission were significantly lower in the treatment group compared with those in the control one (P<0.01=. Conclusion Based on traditional therapeutic(i.e. Cardiotonic agents;Cardiad diuretic agents;Vasodilator and so on), Enalapril combined with Carvedilol to treat CHF to raise sports tolerance and reduced the rate of readmission and death.