厄贝沙坦对风湿性心脏病换瓣术后患者房室重构的作用

Effect of Irbesartan on Heart Remodelling in Patients with Rheumatic Heart Disease after Valve Surgery

目的:探讨厄贝沙坦对风湿性心脏病(RHD)患者换瓣术后心脏形态、容积及功能的影响。方法:50例RHD患者行换瓣术后随机分为对照组和厄贝沙坦组;2组患者在手术后均给予华法林、强心苷、利尿剂等常规治疗;厄贝沙坦组在手术1周后加服厄贝沙坦75～150mg·d-1,疗程为6个月。术后1周、术后6个月经胸超声心动图测量2组患者左、右房室功能和形态的指标。结果:术后6个月,2组与治疗前比较,心脏各腔室均明显缩小,左心室射血分数(LVEF)、右心室射血分数(RVEF)、心脏指数(CI)均明显升高(P<0.05或P<0.01),超声心动图测定的左心室重量指数(LVMI)均明显降低(P<0.05)。厄贝沙坦组经治疗6个月后心脏形态功能和容积各指标较对照组均有明显的改善(P<0.05)。结论:厄贝沙坦能明显改善RHD患者换瓣术后心脏形态、容积及功能。

OBJECTIVE： To evaluate the effects of Irbesartan on cardiac size and its function in patients with rheumatic heart disease （RHD） after valve surgery. METHODS： 50 RHD patients were divided into 2 groups： control group and Irbesartan group. Both groups were given conventional therapy for 6 months. Irbesartan group were additionally treated with Irbesartan （75-150 mg·d^-1）. Ehocardio graphic examinations were performed before and at 6th month after surgery. RESULTS： As compared with before treatment, the atriums and ventricles volume of 2 groups were decreased significantly at 6th month after treatment. The level of LVEF, RVEF, CI of patients were increased significantly after treatment （P〈0.05 or P〈0.01 ） while the level of LVMI of patients were decreased significantly （P〈0.05）. As compared with control group, the cardiac function and its size of Irbesartan group were improved significantly after 6 months of treatment （P〈0.05）. CONCLUSION： Irbesartan can improve cardiac function and its size significantly in RHD patients after valve surgery.