大剂量卡托普利联合厄贝沙坦治疗慢性充血性心力衰竭的疗效观察

Clinical effects of large dosage capoten combined with irbesartan in the treatment of congestive heart failure

目的观察大剂量卡托普利（开搏通）联合厄贝沙坦治疗慢性充血性心力衰竭的临床疗效。方法慢性充血性心力衰竭患者139例随机分为单独大剂量开搏通治疗组（n=61）和在厄贝沙坦片150mg／d基础上逐渐加量开搏通片至最大耐受量组（n=78）。观察8个月后两组在心胸比、左室舒张末期内径、左室收缩末期内径、左室射血分数（LVEF）、6min步行实验、住院次数、病死率等项目的差异。结果8个月后联用厄贝沙坦组住院次数显著减少（P〈0．01）；6min步行距离、左室舒张末和收缩末内径、LVEF等方面与单独开搏通组差异有统计学意义（P〈0.05）；在心胸比、病死率方面无明显差异。结论卡托普利联合厄贝沙坦较单独卡托普利治疗慢性充血性心力衰竭有更优越的临床疗效，值得临床推广。

Objective To evaluate the clinical effects of large dosage capoten（captopril） combined with irbesartan in the treatment of congestive heart failure（CHF）. Methods One hundreds thirty nine patients of CHF were occasionally divided into two groups：large dosage capoten group（ n = 61） and large dosage capoten ＋ irbesartan group （n = 78）. 240 days later, the changes of cardiothoracic ratio（CTR）, left ventricular end diastolic diameter（LEVD）, left ventricular end contract surface （LVES）, left ventricular ejection fraction （LVEF）, 6-minute walking test （6MWT） ,admission frequency,and mortality rate were observed before and after therapy. Results Large dosage capoten ＋ irbesartan group can significantly reduce the admission frequency of CHF patients（ P〈 0.01） , while large dosage capoten group was better than large dosage capoten ＋ irbesartan group in 6MWT, LEVD, LVES, and LVEF （P 〈 0.05 ）. There was no significant difference in CTR and mortality rate between two groups（P 〉 0.05）. Conclusion Capoten combined with irbesartan have better clinical effects than single capoten in the treatment of CHF and it was worthy of extending in clinic.