大剂量卡托普利治疗慢性心力衰竭45例疗效观察

Efficacy of Large Doses of Captoprii for the Treatment of Patients with Chronic Heart Failure

[目的]探讨大剂量卡托普利治疗慢性心力衰竭（CHF）的综合疗效。[方法]回顾性分析本院收治的90例C H F患者的临床资料，根据治疗方案中卡托普利剂量的不同分为高剂量组和低剂量组，每组各45例，其中高剂量组患者每日剂量75．0～150．0 mg ，低剂量组患者每日剂量37．5～75 mg ，比较两组患者治疗后的临床疗效及治疗前后的左室舒张末期内径（LVED ）、左室收缩末期内径（LVESD ）及左室射血分数（LVEF）。[结果]低剂量组患者的总有效率为86．67％，显著低于高剂量组患者的总有效率93．33％，且两组相比较差异有显著性（ P ＜0．05）；治疗前两组患者的LVESD、LVED及LVEF相比较差异均无显著性（ P ＞0．05）；治疗后高剂量组患者的LVESD、LVED均显著小于低剂量组，LVEF显著高于低剂量组，且两组相比较差异均有显著性（ P ＜0．05）。[结论]大剂量卡托普利治疗CHF可显著缩小患者的LVED和LVESD ，提高LVEF ，且临床效果优于低剂量组。

[Objective] To explore the comprehensive efficacy of large doses of captopril for the treatment of patients with chronic heart failure. [Methods] The clinical data of 90 patients with chronic heart failure in our hospital was analyzed retrospectively. According to the dose of captopril in regimen, all patients were di- vided into the high dose group and low dose group with 45 patients in each group. Daily dose in high dose group was 75.0-150.0mg, while that in low-dose group was 37.5-75mg. Clinical efficacy after treatment and left ventricular end diastolic diameter（LVED）, left ventricular end systolic diameter（LVESD） and left ventricular ejection fraction（LVEF） before and after treatment were compared between two groups. [Results] The total effective rate in low dose group was 86. 67%, which was markedly lower than that in high dose group（93. 33%）, and there was significant difference（ P 〈0. 05）. There was no significant difference in LVESD, LVED and LVEF before treatment between two groups（ P 〉0.05）. LVESD and LVED in high dose group after treatment were markedly less than that in low dose group, but LVEF in high dose group was sig- nificantly higher than that in low dose group, and there was significant difference（ P 〈0.05）. [Conclusion] High dose of captopril for the treatment of patients with chronic heart failure can significantly reduce LVED and LVED, and improve LVEF, and its clinical efficacy is superior to low dose group.