依那普利与丹参酮联合治疗肺心病急性加重期临床疗效观察

An observation of clinical efficacy of combined treatment of enalapril and tanshinon on pulmonary heart disease during acute exacerbation

目的探讨依那普利与丹参酮联合治疗慢性肺源性心脏病(肺心病)急性加重期的临床疗效。方法选择200例肺心病急性加重期患者,随机分成四组,每组50例,对照组给予常规基础治疗,依那普利组、丹参酮组和依那普利-丹参酮联合组分别在常规治疗基础上加用依那普利、丹参酮和依那普利-丹参酮,经14 d治疗后比较各组患者治疗前后的疗效、凝血时间(CT)、血小板数(PLT)、血氧饱和度(SaO_2)、平均肺动脉压(MPAP)及血液流变学各项指标。结果治疗后,依那普利组、丹参酮组和依那普利-丹参酮联合组的总有效率分别为80.0%、82.0%和96.0%,显效率分别为50.0%、48.0%和62.0%,与对照组(总有效率30.0%,显效率10.0%)比较均有统计学意义(P<0.01)。各治疗组治疗后CT、SaO_2、MPAP及血液流变学指标等均较对照组明显改善(P<0.01),且联合用药较单一药物治疗效果显著(P<0.05)。结论依那普利与丹参酮联合应用可有效降低肺心病急性加重期患者的肺动脉高压,改善肺源性心脏病症状,是一组安全有效的辅助治疗药物,值得临床推广应用。

Objective To discuss the clinical efficacy of combined treatment of enalapril and tanshinon on chronic pul- monary heart disease （Cot Pulmonale） during acute exacerbation.Methods 200 patients with Cor Pulmonale during acute exacerbation were collected and randomly divided into four groups （eg.control group, enalapril therapy group, tanshinon therapy group and enalapril- tanshinon combined therapy group） with 50 patients in each group.The control group were given conventional therapy, and based on which enalapril was added to the enalapril therapy group, tanshinon was added to the tan- shinon therapy group, and enalapril combined with tanshinon was added to the enalapril -- tanshinon combined therapy group. 14 days after treatment, curative effects, coagulation time （ CT）, platelet count （ PLT）, blood oxygen saturation （ SaO 2 ）, mean pulmonary artery pressure （MPAP） and hemorheological parameters were compared between the 4 groups. Results After treatment, total effective rate of the enalapril therapy group, the tanshinon therapy group and the enalapril -- tanshinon combined therapy group was 80.0%, 82.0% and 96.0% ,respectively, and obvious effective rate was 50.0%, 48.0% and 62.0%, respectively, differences were all statistically significant compared to those of the control group with the total effective rate of 30.0% and the obvious effective rate of 10.0% （P〈0.01）.After treatment, CT,SaO2 ,MPAP and hemorheological parameters of all treatment groups statistically improved compared to those of the control group（P〈0.01 ）, and effects of combined drugs therapy were more significant than that of single drug therapy（P〈0.05）.Conclusion Combined treatment of enalapril and tanshinon can reduce pulmonary hypertension and alleviate the symptoms of patients with Cor Pulmonale.It is safe, and thus is worth being popularized widely in clinical practice.