厄贝沙坦联合卡维地洛治疗慢性心衰的疗效观察

Effectiveness of irbesartan combined with carvedilol in patients with chronic heart failure

目的研究厄贝沙坦与卡维地洛联合应用在慢性心衰患者中的疗效。方法 90例慢性心衰患者,随机分成厄贝沙坦+卡维地洛组(实验组,45例)、卡托普利+倍他乐克组(对照组,45例)。治疗前、治疗3个月后通过彩色多普勒超声心动图来评价其心功能情况,检测指标包括左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD),血清BNP及6min步行实验,并进行比较。结果二组患者治疗后各项指标均有不同程度改善,实验组各指标包括LVEDD、LVESD、LVEF、BNP改善更为明显[(52.8±3.4)vs(57.4±3.7),P=0.034;(41.3±2.7)vs(46.6±3.9),P=0.021;(42.3±3.4)vs(30.6±3.8),P=0.014;(463.8±56.34)vs(508.3±52.74),P=0.017,特别是患者6min步行实验结果(491.5±6.2vs415.4±5.5,P=0.008]。结论厄贝沙坦联合卡维地洛治疗更能改善慢性心衰患者心功能。

Objective To explore the effectiveness of Irbesartan combine with Carvedilol in patients with chronic heart failure （CHF）. Methods Ninety consecutive patients with CHF were divided into two .groups ： experimental group （ treatment with irbesartan and carvedilol, n = 45 ） and control group （ treatment with captopril and Metoprolol, n = 45） randomly. The parameters of LVEDD, LVESD, LVEF, BNP and 6 minutes walk test were compared between before and after 3 months treatment. Results All the parameters were im- proved after 3 months treatment either experimental group or control group. However, the change of LVEDV, LVESV, LVEF, BNP and 6 minutes walk test were more significantly in experimental group [ （52. 8 ±3. 4） vs （57. 4 ±3. 7）, P =0. 034; （41.3 ±2. 7） vs （46. 6 ±3. 9）, P =0. 021 ; （42. 3 ±3.4） vs （30. 6 ±3. 8）, P = 0. 014; （463.8 ±56. 34） vs （508.3 ±52. 74）, P =0. 017; （491.5 ±6. 2） vs （415.4 ±5. 5）, P =0.008]. Conclusion Treatment with Irbesartan combine with Carvedilol will more effectiveness in patients with CHF.