联合用药治疗老年心力衰竭临床观察

CLINICAL OBSERVATION OF COMBINED TREATMENT ON THE SENILE HEART FAILURE PATIENTS

目的 探讨老年人心力衰竭的临床特点及药物治疗的临床疗效。方法 对确诊为心力衰竭的 1 9例患者应用卡托普利、小剂量保钾利尿剂螺内酯及β受体阻滞剂美托洛尔、地高辛治疗观察其临床疗效、NYHA心功能分级变化、左室射血分数、6分钟步行试验及不良反应。结果 心功能明显改善 6例 ,好转 1 1例 ,未愈 0例 ,死亡 2例。左室射血分数由 31 .5± 5 .2 %增加至 45 .2 %±6.7%。差异有显著性 (P <0 .0 0 1 )。6分钟步行试验 ,患者治疗后步行距离由(4.5± 8.7)m增加到 (1 38.1± 1 4 .3)m ,差异显著 (P <0 .0 0 1 )。不良反应轻微 ,基本能耐受。结论 血管紧张素转换酶抑制剂如卡托普利 ,加用利尿剂 ,心功能Ⅱ、Ⅲ级患者加用β受体阻滞剂地高辛治疗老年心力衰竭 ,可提高患者的左室射血分数 。

Objective To evaluate the clinical feature and effects of combined treatment on 19 cases of senile heart failure patients. Methods They were treated with ACEI, diuretic-spironolactone, digoxin and metaprolol agents. Left Ventricle ejection fraction (LVEF) was measured by ultrasound cardiogram (2DE) and 6 minutes gait test, heart function were examined before and after treatment. Results The heart function was improved, the LVEF and working length were increased significantly after treatment (p<0.001). Conclusion Four agents combined treatment can increase the LVEF and working length result in improvement of life quality and viability, it is safe and efficient.