常用剂量苯那普利和缬沙坦联合治疗充血性心力衰竭的临床观察

Effects of benazepril combined with valsartan on congestive heart failure

目的探讨苯那普利、缬沙坦治疗充血性心力衰竭的疗效。方法203例充血性心力衰竭患者在应用洋地黄、利尿剂、β受体阻滞剂治疗的基础上,随机分为A组(n=70):口服苯那普利20mg/d;B组(n=70):口服苯那普利10mg+缬沙坦80mg/d;C组(n=65):口服缬沙坦80mg/d。治疗前、后分别进行心功能(NYHA分级)评估及行超声心动图检查。结果治疗3月后,B组有效率略优于A组(P>0.05),但均优于C组(P<0.05)。左室舒张末期内径、左室收缩末期内径、左心室射血分数均有显著改善(P<0.01)。左室舒张末期内径、左室收缩末期内径及心功能改善总有效率B组比A组略优(P>0.05),但两组较C组显著(P<0.05)。不良反应发生率B、C组均低于A组(P<0.05)。结论常用剂量的缬沙坦与苯那普利联合治疗充血性心力衰竭优于单用苯那普利或单用缬沙坦。

Objective To observe the effects of routine doses ofbenazepril combined with valsartan on congestive heart failure. Methods Totally 203 patients with congestive heart failure were randomized into Group A （receiving benazepril 20 mg/day）, Group B （benazepril,10 mg/day plus valsartan, 80 mg/day）, and group C （valsartan 160 mg/day） for different treatment protocols on the basis of routine therapy for heart failure with digitalis, diuretics and β blockers. The cardiac functions and echocardiographical findings were evaluated before and after the treatments. Results All the patients showed improvement of NYHA class, left ventricular end-diastolic dimension （LVEDd）, left ventricular end-systolic dimension （LVESd） and left ventricular ejection fraction （LVEF） （P〈0.01）, and the effect was better in group B than in group A （P〉0.05）, and both groups A and B had better results than group C （P〈0.05）. No serious adverse effects were found. Conclusion The combination ofbenazepril and valsartan at routine doses can be effective for treating congestive heart failure.