氯沙坦改善慢性充血性心力衰竭患者心功能并降低血尿酸水平

Losartan improves heart function and decreases serum uric acid level in chronic heart failure patients

目的观察血管紧张素Ⅱ受体拮抗剂氯沙坦对充血性心力衰竭的心功能的改善作用及其对血尿酸的影响。方法85例充血性心力衰竭患者在应用强心、利尿、扩血管及β受体阻滞剂治疗的基础上随机分为:氯沙坦组(43例),苯那普利对照组(42例)。治疗前后分别进行心功能评估,血尿酸、心电图、超声心动图等检查。结果治疗前两组间心功能、心率、左室舒张末内径,左室射血分数、心胸比无显著性差异。经治疗3个月、12月后,两组心功能、心率、左室舒张末内径,左室射血分数、心胸比较治疗前均有明显改善(P<0·01)。治疗后两组血尿酸均有不同程度的下降,氯沙坦组治疗后血尿酸较治疗前显著降低36·5%(P<0·01),比苯那普利组下降更显著(P<0·05)。结论氯沙坦既可改善充血性心力衰竭患者的临床症状及心功能,减缓心力衰竭的病程发展,又可作为充血性心力衰竭合并血尿酸增高患者降低血尿酸的有效药物。

Objective To investigate the efficacy of losartan on the improvement of heart function and its effect on uric acid in patients with chronic heart failure （CHF）. Methods Eighty-five patients with CHF were divided into two groups randomly. Routine anti-CHF treatment included cardiotonic, diuresis, isosorbide dinitrate, beta-blockers. In losartan group（ n =43）, patients were given routine anti-CHF treatment and losartan. The patients in control group （n = 42） were treated by routine anti-CHF treatment and Benazapril. The heart functional was evaluated. The content of serum uric acid, electrocardiogram, and Duppler ultransonography were measured before and after treatment respectively. Results The variance of heart function, left ventricle diastoic diameter （ LVDD）, left ventricle ejection fraction （LVEF） and cardiothotic ratio did not show statistical difference. However, they were improved sharply as compared with base-line condition in both groups after 3 months and 12 months treatment （P 〈0. 01 ）. Although the level of serum uric acid was decreased than base-level in both group after 12 months, but the significant change was found only in the losartan group （P 〈 0. 01 ）. Conclusion Losartan is effective and safe for the treatment of chronic heart failure with reducing serum uric acid.