血管紧张素Ⅱ受体拮抗剂对糖尿病患者心功能和死亡率的影响

Effect of valsartan treatment on left ventricular dilatation and systole function and on the cardiac failure in the diabetics

目的探讨缬沙坦对2型糖尿病患者左室收缩和舒张功能的临床疗效。方法糖尿病左室舒张功能障碍患者121例，随机分为缬沙坦组61例，对照组60例，两组均给予硝酸异山梨醇酯10mg一日三次，肠溶阿司匹林每日100mg，缬沙坦组加服缬沙坦每日80～160mg，尼群地平10～20mg一日三次，6个月为一疗程。用超声心动图检查观察两组疗效。结果反映左室收缩及舒张功能指标，缬沙坦组自身比较以及与对照组比较差异有统计学意义（P〈0．05）。临床疗效评定，缬沙坦组总有效率95．1％，明显高于对照组的50．0％，缬沙坦组死亡率为1．6％，对照组死亡率10．0％，两组比较差异有统计学意义（P〈0．05）。结论缬沙坦可改善糖尿病患者的心功能，并可明显降低其死亡率。

Objective To investigate the effects of valsartan treatment on cardiac function in 121 diabetic patients with left ventricular dilatation and diastolic and systolic dysfunctions. Methods The two groups （61 patients for valsartan and 60 patients as control） were randomized . Valsartan 80-160 mg/d, isosorbide dinitrate 10rag tid,aspilin 100mg/d were given to valsartan group. While, valsartan 80-160mg/ d was replaced by niqundiping 10-20rag q 6 h in the control group. After a 6-month period therapy, echocardiography in double-blind method was used to compare cardiac parameters before and after the treatments. Results The indexes of left ventricular remodeling as well as left ventricular diastolic and systolic functions were significantly improved in the therapy group, versus the control group （P〈0.01, P〈0.05）. The total effective rate of cardial function improvement was higher in the therapy group than in control group（95.1% vs 50.0% P〈0. 05）. Fatality rate was lower in therapy group （1.6%）than in the control group （10.0%）. Conclusion Valsartan can reverse the left ventricle dilatation, improve left ventricular diastolic function and reduce fatal rate.