缬沙坦和依拉普利对慢性心力衰竭病人左室重塑的影响对比

Effect of valsautan and ynalapril on the left ventricular remodeling of CCHF

目的对比血管紧张素Ⅱ受体拮抗剂(ARB)和血管紧张素转换酶抑制剂(ACEI)对慢性充血性心力衰竭(SCHF)病人心室重塑的影响。方法将CHF 156例随机分为对照组52例、缬沙坦组52例和依拉普利组52例,于治疗前后进行UCG检查,测定心率(P)、平均动脉压(MAP)、心排量(SV)、左室射血分数(LVEF)、心输出量(CO)、心脏指数(CI)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末内径(LVDd),计算左室心肌重量指数(LVMI),了解二者对心室重塑的阻抑作用。结果缬沙坦组、依拉普利组与对照组比较,除了心率、平均动脉压差异无显著性外,SV、LVEF、CO、CI均明显升高(P<0 05),LVPWT、IVST、LVDd、LVMI均明显降低(P<0 05),而缬沙坦组和依拉普利组的各参数,在治疗前后差异无显著性。结论血管紧张素Ⅱ受体拮抗剂能抑制慢性充血性心力衰竭病人的左室重塑过程,改善左室功能,其效果与依拉普利相近。

Objective:To compare the inhibitory effect of angiotensin11receptor antagonist and angiotensin converting enzyme inhibitor(ACEI)on the left ventricular remodeling(LVRM)of chronic congestive heart failure(CCHF).Methods:156patients with CCHF were randomly divided into control group,valsartan group and ynalapril group,with52cases in each group.P,MAP,SV,LVEF,CO,CI,IVST,LVPWT,LVDd and LVMI were measured by echocardiogrambefore and after treatment.Results:Compared valsautan group and ynalapril group with control group,SV,LVEF,CO and CI were significantly increased,IVST,LVPWT,LVDd and LVMI were significantly decreased(P<0.05),except P and MAP(P>0.05).But there was no difference in all parameters between the vasartan group and ynalapril group.Conclusion:Angiotensin11receptor antagˉonist can inhibit the process of LVRMof CCHF,and improve the left ventricular function.The inhibitory effect of valsartan on LVRMis similar to ynalapril.