不同血管紧张素转换酶抑制剂对老年心衰患者血压的影响

Effects of different angiotensin converting enzyme inhibitors on blood pressure in elderly heart failure patieuts

将６０例老年心衰患者随机分为４组，每组１５例，分别口服卡托普利、依那普利、培垛普利和安慰剂。卡托普利首剂６．２５ｍｇ，２４小时后１２．５ｍｇ、一日三次；依那普利首剂２．５ｍｇ，２４小时后５ｍｇ、一日二次；培垛普利首剂２ｍｇ，２４小时后４ｍｇ、一日一次；均连服二周。结果：首剂卡托普利使平均动脉压（ＭＡＰ）降低２．２３±０．２７ｋＰａ，依那普利使ＭＡＰ降低２．４７±０．４０ｋＰａ，而培垛普利作用不明显；二周后，卡托普利使ＭＡＰ卧位降低１．７３±０．２７ｋＰａ、立位降低２．１３±０．４０ｋＰａ，依那普利分别降低２．０±０．４０ｋＰａ及２．３９±０．４０ｋＰａ，培垛普利使ＡＭＰ卧位降低０．５３±０．２７ｋＰａ、立位舒张压降低０．８０±０．２７ｋＰａ。表明卡托普利、依那普利降压效果肯定，以首剂降压明显；而培垛普利无首剂降压反应，只出现平缓的舒张压降低作用。

Abstract A double-blind placebo-controlled study in a paralleled group of elderly patients with congestive cardiac failure was reported.Altogether 60 patients were randomized into four groups;each group received orally one of the following drugs:captopril.enalapril,perindopril and placebo.The first dose of captopril,enalapril and perindopril was 6.25mg.2.5mg and 2mg respectively and 24 hours later the dose was increased to 12.5mg three times a day.5mg,twice daily and 4mg once daily respectively.Two weeks after treatment,the changes of the levels of blood pressure,plasma renin,angiotensin Ⅱ. aldosterone.creatinine,sodium,potassium and chloride were observed.Results showed that captopril and enalapril had ohvious regponse in reduction of blood pressure,while perindopril had only mild effect on diastolic pressure.