培哚普利对心衰患者心律失常的治疗作用

Therapeutic effects of pendopril on arrythmia in patients with congestive heart failure

在血管紧张素转换酶抑制剂（ＡＣＥＩ）培哚普利使用后，观察心功能及心律失常的变化，以明确ＡＣＥＩ对充血性心力衰竭（ＣＨＦ）患者心律失常的治疗作用。ＣＨＦ患者３５２例随机分为培哚普利组（Ｔ组）和对照组（Ｃ组），Ｔ组在Ｃ组基础上加用培哚普利２ｍｇ／ｄ～４ｍｇ／ｄ，分别在用药前及用药后４个月、１２个月、２４个月进行２４ｈＨｏｌｔｅｒ、心脏二维超声检查测定心功能及左室形态变化。结果Ｔ组４个月、１２个月、２４个月后室早、成对室早、室速及新发室速发生率较Ｃ组明显降低，Ｔ组心源性猝死发生率的降低平行于室速发生率的降低。Ｔ组４个月、１２个月、２４个月后左室射血分数、左室周边缩短率、心指数较Ｃ组明显好转，而左室心肌重量、左室后壁厚度、左室舒张期末径较Ｃ组亦改善明显。可见ＡＣＥＩ可通过改善ＣＨＦ患者心功能及左室重构，降低室性心律失常发生率及降低心源性猝死发生率。提示ＡＣＥＩ是降低ＣＨＦ患者心源性猝死的有效药物。

Objective:The changes in cardiac function and ventricular arrythmia were observed in patients with congestive heart failure (CHF) to investigate the therapeutic effects of pendopril,a angiotensin converting enzyme inhibitor,on arrythmia. Methods:Three hundred and fifty two patients with CHF were randomized into the pendopril treated group (TG) and the control group (CG). The patients in TG were treated with pendopril at a dosage of 2 mg/d￣4 mg/d. The 24 h Holter was determined and cardiac function and changes in left ventricular morphology were investigated with ultrasonography before and at the 4th,12th and 24th month after the treatment. Results:The occurring rates of ventricular premature beat,couple ventricular premature beat,ventricular tachycardia and new formed ventricular tachycardia were significantly lower in TG than in CG at the 4th,12th and 24th month after the treatment. The decrement of the occurring rate of cardiogenic sudden death paralleled the decrement of the occurring rate of ventricular tachycardia. At the 4th,12th and 24th month after the treatment,EF mVcf,CI,LVM,PWT and Dd were markedly improved in TG as compared with CG. Conclusion:Pendopril can decrease the occurring rate of ventricular arrythmia and the rate of cardiogenic sudden death through improving cardiac function and left ventricular remodeling,which suggests that pendopril is a effective agent to decrease the rate of cardiogenic sudden death in patients with CHF.