氯沙坦联合卡托普利治疗心衰疗效的研究

Study of the effect of combing losartan with captopril in patients with congestive heart failure

目的:探讨氯沙坦联合卡托普利治疗充血性心力衰竭(CHF)的血流动力学和神经内分泌改变的临床意义。方法:60例充血性心力衰竭患者在维持原强心、利尿、扩血管等基础上随机分为卡托普利组、氯沙坦组和氯沙坦联合卡托普利组共3组,对照组25例为健康体检者。治疗前后测定血管紧张素Ⅱ(AⅡ)、ET、一氧化氮(NO)、射血分数(EF)和右室舒张末期容积(LVEDV)。结果:3组患者在治疗前AⅡ、ET增高,NO降低,较对照组差异有显著性(P<0.01)。治疗后各组自身对照,AⅡ、ET和LVEDV降低,EFF和NO增加,差异亦有显著性(P<0.0l)。联合组较单用组其AⅡ、ET和LVEDV降低与EF和NO增加差异有显著性(P<0.05) ,两组单用组比较差异不显著(P>0.05)。结论:CHF是发生了神经内分泌紊乱,单用卡托普利或氯沙坦能改善神经内分泌紊乱和血流动力学。

Objective:To study the effect of captopril and losartan on blood stream dynamics and nerve endocrine in patients with congrestive heart failure(CHF),as well as its clinical significance.Methods:Sixty patients with CHF were randomly divided into three groups,which were captopeil group,losartan group,and combined group,twinty-five health persons served as control group.Before and after treatment,angiotensin(AngⅡ),endothelin(ET),nitric oxide(NO),ejection fraction(EF) and left ventricular end-diastolic volume(LVEDV) were measured.Reuslts:Before treatment,the level of AngⅡand was higher in patients with CHF than those in the control group,on the contrary,NO was decreased(P<0.01).After treatment,the level of AngⅡ、ET and LVEDV was significantly decreased,while EF and NO were obviously decreased(P<0.01),and the effect of combined use was better than that of single use(P<0.05),but there was no difference between the two single use groups(P>0.05).Conclusion:Nerve endocrine has taken place disturbance in CHF,which and the changes of blood stream dynamics can be improved by either captopril or losartan,but the effects of combined use are better than that of single use.