卡托普利治疗慢性心力衰竭长期疗效分析

Long-term effect of captopril in chronic heart failure

目的 观察应用血管紧张素转换酶抑制剂卡托普利协同治疗慢性心力衰竭(CHF)的预后。方法 65例CHF 患者分为对照组24例,采用地高辛、利尿剂、硝酸酯类及β-受体阻滞剂等综合疗法;治疗组41例,在上述基础上加用卡托普 利。结果 5年观察期间,对照组和治疗组因心力衰竭加重再住院率分别为75.0％和26.8％(P<0.001),病死率分别为 29.17％和7.32％(P<0.01);在观察期满时对心功能NYHAⅡ-Ⅲ级患者复查,与治疗前相比,治疗组心功能、最大运动功 率、运动持续时间及6min步行距离均明显提高(P<0.01),心脏超声测定心搏量(SV)、心输出量(CO)及射血分数(LVEF) 结果示均明显改善(P<0.01);而对照组各项指标无明显改善。结论 协同其他治疗CHF的基本药物。卡托普利可显著改 善CHF患者的长期预后。

Objective To investigate the long-term effects of angiotension converting enzyme inhibitor (ACEI) captopril in chronic heart failure(CHF). Methods 65 CHF patients were divided into 2 groups. The control group received digoxin、diuretics、nitroglycerin and β-blocker. The treated group received captopril in addition. Results In 5 years,rate of re-hospitalization in control group and treatment group are 75.0% and 26. 8% respectively (P<0.001 );mortality are 29. 17% and 7.32% respectively (P<0.01). The cardiac function、ultimate power of movement、enduring time of movement and six minute walking distance are increased in treatment group the patients with NYHA class Ⅱ and Ⅲ at the endpoint of treatment compared to those items before treatment (P<0.01). The stroke volume(SV)、cardiac output(CO) and left ventricular ejection fraction(LVEF) by Doppler echocardiography are improved (P<0.01),while the control group have no changes.Conclusions Captopril combining with other drugs to treat CHF basically,can significantly improve the long-term prognosis of patients with CHF.