缬沙坦治疗慢性充血性心力衰竭的临床价值

Valsartan treatment of chrouic congestive heart failure chinical value

目的探讨缬沙坦治疗慢性充血性心力衰竭（CHF）的临床价值。方法80例CHF患者在常规治疗的基础上（洋地黄、利尿剂、血管扩张剂）随机分为依那普利组（n=40），服依那普利2．5～20mg／d，缬沙坦组（n=40），服缬沙坦40—160mg／d。共治疗6个月。治疗前后分别进行心功能评估，记录6min步行距离，观察心脏超声心动图指标变化。结果两组治疗后与治疗前比较，心功能（NYHA分级）及6min步行距离均有显著改善（P〈0．01）。左室射血分数、左室收缩末期容量、左室舒张末期容量均有显著改善（P〈0．01）。而治疗后两组间比较以上各指标差异无显著性（P〉0．05），不良反应发生率两组比较有显著差异（P〈0．05）。结论缬沙坦与血管紧张素转换酶抑制剂依那普利一样，治疗CHF疗效显著，且耐受性更好。

Objective This study was to investigate the clinical value of Valsartan on congestive heart failure （CHF） Methods 80 cases of congestive heart failure in patients on the basis of conventional therapy （ digitalis, diuretics, vasodilators） were randomly divided into enalapril group （ n = 40 ） , served enolapril 2. 5 20 mg/d, valsartan group （ n = 40 ） , served valsartan 40 - 160 mg/d. for a total of six months. The changes in the heart function and the distance for 6 minutes walking test cardiac echocardiogrphic parameters were assessed be- fore and after treatment. Results After 6 months therapy, cardiac function （ NYHA classification） ,distance for 6 minutes walking test,left ventricular ejection fraction （EF） ,LV end-distolic volume （EDV） ,LV end-systolic volume （ESV） were improved significantly in both groups （P 〈 0. 01 ）, but after treatment between the two groups above indicators there was no significant difference （ P 〈 0. 05 ）. The incidence of side effects between two groups was significant difference （ P 〈 0. 05 ）. Conclusion Valsartan is as effective as enalapril in the treatment of the patients with CHF and it is well tolerated.