卡托普利对慢性肺心病难治性心力衰竭近期疗效的评价

Short-term effects of captopril on refractory heartfailure in patients with chronic cor pulmonale

对３０例心功能Ⅲ～Ⅳ级慢性肺心病难治性心力衰竭患者，应用卡托普利短期治疗后心功能明显改善，总有效率９３．３％，血浆血管紧张素Ⅱ、醛固酮、心钠素浓度明显下降（Ｐ＜０．０１），肺动脉平均压、肺血管阻力、右室平均压、总外周阻力明显下降（Ｐ＜０．０１），心排血量、每搏量、射血分数增加（Ｐ＜０．０５或０．０１），未见明显副作用。提示卡托普利对慢性肺心病难治性心力衰竭患者心功能的改善作用显著。

30 patients with refractory heart failure(NYHA functional class Ⅲ or Ⅳ)secondarv tochronic pulmonary heart disease were studied.Heart function, renin-angiotensin-aldosterone system,artrial natriuretic peptlde and hemodynamicswere observed before and after short-term captopriltherapy,The results showed that the heart functionwas markedlyimproved and the overall effectiveratereached to 93.3%. Plasma angiotensin Ⅱ,aldosterone and artrial natriuretic peptideweresignificantly decreased (P<0.01).Mean pulmonaryartery pressure, pulmonaryvascular resistance , meanright ventricular pressure and total systemic vascularresistance were significantly decreased(P<0.01).Cardiac output,stroke volume and ejection fractionwere increased(P<0.05 or<0.01).No serious sideeffect was noted.It is suggested that captopril hassignificant effects on the improvement of heart func-tion in patients with refractory heart failure due tochronic cor pulmonale.