培哚普利对慢性稳定型冠心病合并舒张功能不全患者的影响

The effect of perindopril on patients with chronic stable coronary artery disease combined with diastolic dysfunction

目的探讨培哚普利(雅施达)对慢性稳定型冠心病合并舒张功能不全患者的临床影响。方法将106例患有慢性稳定型冠心病合并舒张功能不全患者,随机分成治疗组(52例)和对照组(54例)。2组患者均给于冠心病常规治疗,其中治疗组患者加用培哚普利4～8mg/d,疗程6月。疗程结束后,采用运动平板试验和彩色多普勒心脏超声,评价患者的临床症状与左心室舒张功能指标的改善情况。结果治疗组总有效率优于对照组(69.4%比52.9%,P<0.01);治疗组治疗后运动耐量增加[(6.3±2.4)met和(9.5±1.8)met,P<0.01)];左心室舒张功能指标除LVPW、LVEF外均有改善(P<0.05～0.01),而对照组在治疗前后无明显差异(P>0.05),左室舒张功能指标除AcTe、DcTe、IRT有改善外(P<0.05),其余均无显著改善(P>0.05)。结论培哚普利能减少慢性稳定型冠心病患者的缺血症状,增加其运动耐量,纠正左心室舒张功能不全,从而改善其预后。

Objective To study the efficacy of perindopril （Acertil） on patients with chronic stable coronary artery disease combined with diastolic dysfunction.Methods 106 patients with chronic stable coronary artery, disease combined with diastolic dysfunction were randomized to two groups, 52 cases in treatment group and 54 cases in control group. The patients in both groups were treated by routine therapy. The patients in treatment group were given perindopril 4 - 8 mg/d, with a treatment course of 6 months. The clinical symptoms and indexes of left ventricular diastolic function were examined by exercise test and Doppler echocardiography. Results After treatment, the total effective rate in treatment group was superior to that of control group（69.4% vs 52.9%, P 〈 0.01） ;exercise capacity was significantly increased [ （6.3 ± 2.4）met vs （9.5 ± 1.8）met, P 〈 0.01] and indexes of left ventricular diastolic dysfunction （except for LVPW and LVEF） were obviously improved （ P 〈 0.05 or P 〈 0.0! ）. However in control group only AcTe, DcTe and IRT improved significantly （ P 〈 0.05）, there was no significant change in other indexs before and after treatment （ P 〉 0.05）. Conclusion Perindopril can improve the ischemic symptoms and diastolic dysfunction in patients with chronic stable coronary artery disease, as a result, which could improve its prognosis.