缬沙坦在扩张性心肌病中的临床应用

Clinical application of Valsartan in treatment of the patients with dilated cardiomyopathy

目的:观察血管紧张素Ⅱ受体拮抗剂缬沙坦治疗扩张型心肌病(DCM)的可行性和安全性。方法:将64例DCM患者随机分为观察组36例和对照组28例。对照组采用一般常规治疗,观察组在常规治疗基础上加用缬沙坦。观察并比较2组患者治疗前后心功能改变、临床效果及不良反应。结果:观察组与对照组治疗后心功能指标均较治疗前明显改善(P<0.05);观察组心功能指标较对照组改善明显,两组比较,差异有统计学意义(P<0.05)。观察组和对照组总有效率分别为83.33%(30/36)和64.29%(18/28),两组总有效率比较,差异有统计学意义(P<0.05)。观察组中3例出现头昏、头痛、心悸、腹痛、消化不良等副作用,经对症处理后症状缓解,未影响后续治疗,未发生肾功能不全、低血压及高血钾。结论:一般常规治疗基础上加用缬沙坦可显著改善DCM患者临床症状和左室收缩及舒张功能,无明显毒副作用,疗效确切,安全可靠。

Objective： To observe the feasibility and safety of the angiotensin Ⅱ receptor antagonist Valsartan in the treatment of dilated cardiomyopathy （DCM）. Methods： 64 patients with DCM were randomly divided into observation group （36 cases） and control group （28 cases）. General routine treatment was used in the control group, based on the control group the observation group used Valsartan. Clinical effects and adverse reactions were observed and compared in the two groups before and after treatment in patients with cardiac function. Results： After and before treatment, heart function parameters were significantly improved （P〈0.05）. The cardiac function improved significantly in the observation group compared with the control group （P〈0.05）. In the observation group and control group, the total effective rate was 83.33% （30/36） and 64.29% （18/28） respectively. There was a significant difference in two groups （P〈0.05）. In the observation group, 3 cases of dizziness, headache, palpitations, abdominal pain, indigestion and other side effects, symptom relief by symptomatic treatment, did not affect the follow-up treatment. There was no renal failure, hypotension and hyperkalemia. Conclusion： The general basis of conventional therapy plus Valsartan could significantly improve clinical symptoms in patients with DCM and left ventricular systolie and diastolie function, without apparent side effects, effeetive, safe and reliable.