厄贝沙坦联合雷米普利在风湿性心脏病慢性心力衰竭患者中的作用

Ramiprii in combination with irbesartan for treatment of chronic heart failure in patients with rheumatic heart disease

目的:观察厄贝沙坦联合雷米普利在风湿性心脏病慢性心力衰竭患者中的作用。方法:120例风心瓣膜置换术后慢性心力衰竭患者随机分为试验组(60例)和对照组(60例)。所有患者常规给予雷米普利5mg,1/d治疗,试验组加用厄贝沙坦150 mg,1/d。随访6个月.观察指标为心功能(纽约心脏协会,NYHA)分级、6min步行实验、超声心动图各参数。结果:治疗6个月后,试验组较对照组心功能分级、6min步行实验、超声心动图各项指标(左室舒张朱期内径、左室收缩末期内径、左室射血分数、短轴缩短率)均改善明显(P<0.05)。结论:厄贝沙坦联合雷米普利可显著改善风心慢性心力衰竭患者心功能、逆转心室重塑。

Objective： To investigate the effectiveness of irbesartan in combination with ramipril for treatment of chronic heart failure in patients with rheumatic heart disease （RHD）. Methods：A total of 120 RHD patients with chronic heart failure were randomized into treatment group （n=60） and control group （n=60） after valve replacement. All patients received regular ramipril treatment （5 mg/d）; treatment group were also given irbesartan （150 mg/d）. The patients were followed up for 6 months. The indices of observation included cardiac function （NYHA Class）, 6-Minute Hall-Walk distance, and echocardiographic parameters. Results： Six months later the cardiac function in the treatment group was obviously improved compared with the control group; the patients in the treatment group had significant increase in 6-Minute Hall-Walk distance and improvement in echocardiographic parameters （left ventricle end-systolic diameters, end-diastolic diameter,ejection fraction, fractional shortening,P〈0.05）. Conclusion.lrbesartan in combination with ramipril can obviously improve the cardiac function and reverse ventricle remodeling in RDH patients with chronic heart failure.