咪达普利与卡维地洛单用及合用治疗老年人心力衰竭的临床疗效观察

Observation of clinical effects of imidapril and carvediol,when used alone or in combination,in treating heart failure in the elderly

目的比较ACE抑制剂咪达普利和β受体阻滞剂卡维地洛单独及联合应用对老年人心力衰竭的长期临床疗效,为临床治疗药物的合理应用提供依据。方法212例老年心衰患者,平均年龄(74.9±6.1)岁,其中男134例,女78例,随机分为咪达普利组(n=71)、卡维地洛组(n=68)和咪达普利+卡维地洛组(n=73),治疗12个月,监测治疗前后HR、SBP、DBP、LVEF、LVEDD和LVMI的变化。结果对于212例老年患者实施不同的治疗方案后均有较好的效果。卡维地洛组、咪达普利组和咪达普利+卡维地洛组均使LVEF增加,SBP、DBP、LVEDD和LVMI明显降低,对HR影响较小。与卡维地洛组、咪达普利组比较,卡维地洛+咪达普利组的心脏特征指标改变更加明显。结论卡维地洛与咪达普利联合应用对于老年心力衰竭治疗效果优于单独使用。

Objective To compare the long-term clinical effects of the ACE inhibitor of imidapril and the βacceptor of carvediol, when used alone or in combination, on the treatment of heart failure in the elderly, in order to provide references for reasonable administration of the clinical and therapeutic drugs. Methods There were 212 geriatric patients suffered from heart failure having the average age of （74.9 ± 6.1）, with 134 males and 78 females. They were randomly divided into three groups, including the imidapril group （n = 71）, the carvediol group （n=68）, and the group of imidapril and carvediol （n=73）. The changes of heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, left ventricular ejection fraction （LVEF）, left ventricular end diastolic dimension （LVEDD） and left ventricular mass index （LVMI） were measured after a 12-month treatment. Results There were good effects in the 212 geriatric patients after being administrated with the different therapeutic projects. LVEF in the three groups increased, while SBP, DBP, LVEDD and LVMI reduced significantly. But, there was a little influence on HR. Furthermore, the changes of the heart feature indexes in the group of imidapril in combination with carvediol were more evident than those in the imidapril group or the carvediol group. Conclusions The effectiveness of carvediol in combination with imidapril on the geriatric heart failure was superior to that of carvediol or imidapril alone.