依那普利倍他乐克安体舒通联合治疗慢性心力衰竭疗效观察

Observing the Effect of Enalapril Betaloc Spironolactone on Chronic Heart Failure

目的:探讨依那普利、倍他乐克、安体舒通联合治疗慢性心力衰竭疗效。方法:对2008年1月至2013年6月在重庆北部新区第一人民医院住院确诊的慢性心力衰竭患者326例进行回顾分析,治疗组168例,在常规抗心衰治疗的基础上加用倍他乐克、依那普利、安体舒通。对照组158例只进行常规抗心衰治疗,对两组进行治疗前后对比分析。结果:临床疗效比较:治疗组显效88例(52.3%),有效68例(40.4%),无效12例(7.3%),总有效率92.7%。对照组显效40例(25.2%),有效56例(36.2%),无效62例(38.6%),总有效率61.4%。两组总有效率差异有统计学意义(P<0.05)。心脏多普勒超声比较:两组治疗后3个月测定心功能与左室内径等指标,治疗组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均下降、左室射血分数(LVEF)均增加,治疗组在治疗前后对比具差异有统计学意义(P<0.05)。治疗组与对照组比较也有显著差异性(P<0.05)。对照组治疗前后上述指标改变不明显,差异无统计学意义(P>0.05)。结论:倍他乐克、依那普利、安体舒通联合治疗慢性心衰能更好地改善心衰患者的症状,改变左室重构,提高左室射血分数,提高心衰患者有效治疗率,降低住院率。

Objective： To explore the efficacy of enalapril , betaloc, spironolactone on chronic heart failure .Method：326 cases of patients with chronic heart failure from 2008 January to 2013 June in the First People＆#39;s Hospital of Chongqing new North Zone were analyzed retrospectively , and 168 cases in the treatment group, combined with betaloc , enalapril spironolactone , based on conventional anti heart failure treatment . 158 cases in the control group only received conventional anti heart failure treatment , the two groups were compared before and after treatment .Result： The clinical curative effect in treatment group were 88 cases （ 52.3%） , effective in 68 cases （ 40.4%） , invalid 12 cases （ 7.3%） , the total efficiency was 92.7%.The control group were 40 cases （25.2%）, effective in 56 cases （36.2%）, invalid 62 cases （38.6%）, the total efficiency was 61.4%.The total efficiency of two groups had significant difference （ P 〈0.05） .Comparison of doppler echocardiography：measurement of cardiac function and left ventricular diameter for a period of 3 months after the treatment in the two groups , the treatment group of left ventricular end diastolic diameter （ LVEDD） , left ventricular end systolic diameter （ LVESD） were decreased , left ventricular ejection fraction （ LVEF） were increased , patients in the treatment group were compared before and after treatment with different statistical significance （P 〈0.05）.The treatment group compared with the control group had significant difference （P 〈0.05）.The control group before and after treatment the index did not change significantly, the difference was not statistically significant （P〉0.05）.Conclusion： Betaloc, enalapril, spironolactone in the treatment of chronic heart failure can improve the patients with heart failure symptoms , changes the left ventricular remodeling , improve left ventricular ejection fraction , improve the effective rate of patients with heart failure , reduce the rate of hospitalization .