氯沙坦钾与卡托普利治疗老年充血性心力衰竭的比较研究

Comparison of losartan and captopril in the treatment of congestive heart failure in elderly

目的 :本文研究旨在比较氯沙坦钾 (Lo)加入抗心衰治疗方案与卡托普利 (Ca)治疗的临床疗效 ,并评估其近期治疗的安全性。方法 :对 6 0例缺血性和非缺血性心脏病心功能Ⅲ～Ⅳ级患者 1～ 2周基础抗心衰调整期后 ,一组加用Lo 5 0mgqd ,另一组加用Ca 12 .5mgTid～ 2 5mgBid ,观察 4周。并通过临床NYHA分级、运动耐量和心超心功能检查比较 2组组疗效。结果 :1 临床疗效 :Lo组总有效率86 6 % ,Ca组总有效率 70 % (P >0 0 5 ) ;2 运动耐量 2组治疗后运动时间均有明显增加。而且MET均有提高 ;3 心超心功能检查 ,提示Lo对舒张功能改善较Ca组明显 ;4 Lo组 30例全部完成观察期 ;Ca组有4例因不良反应被迫停药 ,改用Lo而完成治疗。结论 :氯沙坦钾与卡托普利治疗以收缩功能不全性老年心力衰竭具有相似疗效 ,前者对舒张功能不全的改善有所帮助 ;而且病人对氯沙坦钾的依从性优于卡托普利 ,副反应小 ,适宜长期应用。

Purpose:The aim of this study was to compare the clinical efficacy and safety of losartan potassium(Lo)and captopril(Ca)in the treatment of congestive heart failure of the elderly.Methods:60 in hospital cases of ischemic and non-ischemic heart diseases,age≥60 years,with cardiac function NYHA Ⅲ～Ⅳ were treated with Lo 50 mg Q.D.(30 cases)or Ca 12.5 mg Tid ～25 mg Bid(30 cases)after 1～2 week observation period with basic anti-heart failure treatment,exercise tolerance and echocardiogram were performed before and after 4 weeks of treatment.Results:1. Clinic cardiac function improved in 86.6% of the Lo group and 70% in the Ca group( P >0 05). 2. The exercise time prolonged and MET increased in both groups. 3. LVEF and mitral doppler blood flow VA/VE improved in both group. 4. Adverse effects were less in the Lo group,4 cases in Ca group were withdrawn and substituted by Losartan because of severs cough.Conclusion:1. Both of the druge had similar effect in the treatment of CHF in the elderly.There was a better improvement in diastolic function in Lo group than Ca group.2. Adverse effects were less and compliance was better in the Lo group.