坎地沙坦治疗慢性充血性心力衰竭50例临床观察

Clinical observation of treatment with candcsartan on chronic congestive heart failure

目的观察坎地沙坦治疗慢性充血性心力衰竭(CHF)的临床疗效及安全性。方法选择98例病因不同的CHF患者,随机分为两组。两组患者均给予强心、利尿、β受体阻滞剂和扩血管等常规治疗,对照组加用福辛普利钠10 mg/d(起始剂量可为2.5 mg/d);治疗组加用坎地沙坦8 mg/d(起始剂量可为2 mg/d),疗程均为6个月。检测两组治疗前后左心室功能和心脏形态超声心动图参数的变化。结果治疗组与对照组临床疗效比较差异无统计学意义(P>0.05);治疗后两组的左室射血分数(LVEF)、短轴缩短率(FS)均有增加,左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)均有减少,两组治疗后与治疗前相比较上述四项参数有显著差异(P<0.05);治疗后治疗组与对照组比较上述四项参数差异无统计学意义(P>0.05);两组不良反应发生率比较有显著差异(P<0.05)。结论坎地沙坦与福辛普利治疗CHF疗效相当,均能逆转左心室心肌重构,但坎地沙坦更安全耐受。

Objective To observe the clinical efficacy and safety of chronic congestive heart failure with candesartan. Methods 98 cases of different etiology in patients with CHF were randomly divided into two groups. 2 groups were given cardiac,diuretic, 13 -blockers, and Vasodilators, such as conventional treatment, the control group plus fosinopril 10 mg/d （ starting dose for the 2.5 mg/d） ;the treatment group were Candesartan 8 mg/d（ starting dose for the 2 mg/d） ,treated for 6 months. Detection of two groups before and after treatment in the form of left ventficular function and cardiac echocardiography parameters change. Results The results of the treatment group and clinical efficacy of the control group no significant difference （ P 〉 0. 05 ） ; the two groups after treatment of left ventricular ejection fraction （ LVEF）, fractional shortening （FS） have seen increases in both LVEDD（LVEDd） ,left vcntricular end systolic diameter （LVESd） ,there was a decline,2 group after treatment compared with pretreatment of these four parameters were significantly different （P 〈 0. 05 ） ;the treatment group after treatment compared with control group, the four parameters There was no significant difference（ P 〉 0. 05 ） ;the incidence of adverse reactions were more significant differences （ P 〈 0. 05 ）. Conclusion Candesartan treatment of CHF with fosinopril considerable effect can reverse left ventricular remodeling, but more secure Candesartan tolerance.