氯沙坦和贝那普利联合治疗对心衰患者左室舒张功能康复的临床疗效

Effectiveness of losartan and benazepril in improving diastolic function of left ventricle in patients with heart failure and hypertension

目的：探讨氯沙坦和贝那普利联合用药对高血压性心衰患者左室舒张功能的临床疗效。方法：把91例高血压伴心功能不全患者随机分为治疗组（n=61）和对照组（n=30）。治疗组患者口服氯沙坦50～100mg／d＋贝那普利10mg／d＋地高辛0．125～0．25mg／d＋阿司匹林100mg／d＋氢氯噻嗪25mg／d或呋塞米20mg／d；对照组患者的治疗方案除无氯沙坦外，其余与治疗组相同。6个月为一个疗程。治疗前后检测患者的心脏舒张功能指标（E峰、A峰、E／A比值）。结果：治疗组患者治疗3个月后的左室舒张功能同治疗前比较具有极显著性差异，与对照组治疗后比较P〈0．05。对照组治疗3个月时上述指标无明显改变（P〉0．05）。临床疗效评定：治疗组患者心功能改善的总有效率为95．08％，对照组总有效率为66．67％，有极显著性差异（P〈0．01）。结论：氯沙坦和贝那普利联合用药可改善高血压伴心衰患者的左室舒张功能。

Objective： To study the effectiveness of combined treatment with losartan and benazepril in improving the diastolic function of left ventricle in patients with heart failure and hypertension. Methods： Ninety-one patients with cardiac insufficiency as well as hypertension were randomly divided into treatment group （n = 61） and control group （n = 30）. Patients in treatment group took losartan 50-100 mg/d, benazepril 10 mg/d, digoxin 0. 125-0.25 mg/d, aspirin 100 mg/d and hydrochlorothiazide 25 mg/d or furosemide 20 mg/d. Patients in control group took the same drugs except losartan. The treatment was lasted 6 months. The values of peak E, peak A and the ratio of E/A were determined before and after treatment. Results： The diastolic function of left ventricle in treatment group changed significantly after the treatment compared with the control group （P〈0.05）. In control group the above indicators did not show remarkable change after 3 months of treatment （P〉0.05）. The total effective rate of treatment group was 95.08%, which was significantly different from the control group 66.67% （P〈 0.01 ）. Conclusion： The combined treatment with losartan and benazepril can improve the cardiac function of patients with heart failure as well as hypertension.