伊贝沙坦与依那普利治疗老年慢性心力衰竭疗效比较

The curative effect comparison of irbesartan and enalapril in the treatment of elderly patients with chronic cardiac failure

目的:比较伊贝沙坦与依那普利治疗老年慢性心力衰竭(CHF)的临床疗效及安全性。方法:72例老年CHF患者在常规治疗基础上随机分为两组,伊贝沙坦(150mg/d,37例)组与依那普利(10～20mg/d,35例)组,疗程为6个月。结果:疗程结束后,伊贝沙坦组临床显效率45.9%,有效率48.6%,无效率5.4%,总有效率94.6%;依那普利组分别为48.6%、43.2%、5.7%、94.3%,两组间比较差异无显著性。与治疗前比较,两组在左心室质量指数、左心室射血分数、左心室舒张末期内径、左心室收缩末期内径等相关参数均有显著改善(P<0.01);血压有所下降(P<0.05),但均在正常范围内;除刺激性干咳发生率伊贝沙坦组明显低于依那普利组外,两组均未见其他明显不良反应。结论:伊贝沙坦治疗老年CHF与依那普利疗效相似,且不良反应少,可作为不能耐受ACEI类药物的老年CHF病人的优先选择。

Objective： To compare the clinical efficacy of irbesartan with that of enalapril in the treatment of elderly patients with chronic cardiac failure （CCF）. Methods：On the basis of conventional therapy,72 elderly patients with CCF were randomly divided into two groups ：irbesartan group（n=37）was treated with irbesartan（150mg daily） and enalapril group （n= 35） was treated with enalapril （10-20mg daily）. The course of treatment was 6 months in both groups. Results： After treatment, the cardiac function, LVMI, LVEF, LVEDd and LVESd were markedly improved in both groups, but with no statistical difference between the two groups. In spite of lowered blood pressure, the blood pressure was in normal range in the both groups. Irbesartan group was well tolerated and showed lower incidence of cough compared with enalapril group. Conclusion. Irbesartan and enalapril have similar efficacy in the treatment of the elderly CCF patients,but irbesartan is more tolerable and reliable than captopril. Irbesartan is more suitable for the elderly CCF patients and may be used as the first alternative in patients with intolerance of ACEI.