缬沙坦联合依那普利治疗充血性心力衰竭的临床疗效观察

Clinical study of the treatment of patients with congestive heart failure by using valsartan combined with enalapril

目的观察缬沙坦与依那普利联合治疗充血性心力衰竭（CHF）临床疗效。方法将40例CHF患者随机分为2组：治疗组20例，口服缬沙坦80mg／d，依那普利5～10mg／d；对照组20例，口服依那普利5～10mg／d。治疗前、后分别进行心功能（NYHA分级）评估，行血生化、肝肾功能、心电图、超声心动图检查。结果治疗8周后2组心功能（NYHA分级）、左房内径（LA）、左室舒张末期容量（LVEDV）、左室收缩末期容量（LVESV）、左心室射血分数（EF）、短轴缩短率（FS）、心输出量（CO）、心排血指数（CI）均有显著改善（P〈0．05）。LVEDV、LVESV、EF、FS治疗组与对照组比较改善更为显著（P〈0．05）。2组治疗前、后血生化、肝肾功能均无显著变化，不良反应发生率相仿（P〉0．05）。结论缬沙坦联合依那普利可应用于CHF且优于依那普利。

Objective To probe the treatment of patients with congestive heart failure （CHF） by using valsartan combined with enalapril. Methods Forty patients were randomly divided into two groups. Treatment group （n= 20）was given valsartan 80 mg/d and enalapril 5-10 mg/d. Contol group（n=20）was given enalapril 5-10 mg/d. The changes of NYHA rating,biochemistry,liver and renal function,electrocardiogram and echocardiography were observed. Results After eight weeks＇ therapy,NYHA rating ,LA atrium diameter ,LV end-distolic volume （EDV）,LV end-systolic volume （ESV）, left ventricular ejection fraction （EF）, fraction shortening （FS）, cardiac output （CO）, cardiac index （CI） were improved significantly in both groups （P 〈 0.05 ）. LVEDV,LVESV,EF and FS were more remarkable in treatment group than those in control group（P〈0. 05）. There was no significant difference in adverse reaction and liver,renal function between the two groups（P〉0.05）. Conclusion Combining valsartan with enalapril can be used in the treatment of patients with CHF and is more effective.