氯沙坦钾氢氯噻嗪片对慢性心衰患者心功能的影响及院后康复的效果研究

A study on the effect of losartan potassium and hydrochlorothiazide tablets on cardiac function and post-hospital rehabilitation in patients with chronic heart failure

目的探究氯沙坦钾氢氯噻嗪片(商品名:海捷亚)对慢性心力衰竭(慢性心衰, CHF)患者心功能及院后康复效果的影响。方法 60例CHF患者,按照入院时间顺序,尾数单数的患者为观察组,尾数双数患者为对照组,每组30例。对照组使用马来酸依那普利片、呋塞米、螺内酯、地高辛联合治疗,观察组采用呋塞米、螺内酯、地高辛联合氯沙坦钾氢氯噻嗪片治疗。比较两组患者入院当天、治疗14 d、出院90 d的脑钠肽(BNP)、左心室射血分数(LVEF)与明尼苏达量表评分。结果入院当天,两组患者的BNP、LVEF及体力维度、情感维度、总维度评分比较,差异均无统计学意义(P>0.05)。治疗14 d后,观察组患者BNP(402.85±62.58)pg/ml、情感维度评分(5.99±1.92)分、总维度评分(33.68±4.52)分均优于对照组的(443.27±68.23)pg/ml、(6.78±1.46)分、(37.35±4.93)分,出院90 d的BNP(306.31±59.56)pg/ml、LVEF(47.20±2.03)%、体力维度评分(10.72±2.09)分、情感维度评分(4.08±1.75)分、总维度评分(25.23±4.39)分均优于对照组的(341.46±63.22)pg/ml、(43.22±2.76)%、(13.85±2.93)分、(5.75±2.25)分、(33.69±4.55)分,差异均具有统计学意义(P<0.05)。观察组患者治疗14 d的LVEF(42.85±2.85)%、体力维度评分(14.68±2.96)分略优于对照组的(42.09±3.03)%、(15.02±3.14)分,但差异无统计学意义(P>0.05)。结论氯沙坦氨氯噻嗪片可有效改善CHF患者心功能的同时,并配合院后康复管理指导患者院中院后治疗,可有效提升患者生活及生存质量,特别在提升远期效果更为突出。

Objective To study the effect of losartan potassium and hydrochlorothiazide tablets(trade name: Hyzaar) on cardiac function and post-hospital rehabilitation in patients with chronic heart failure(CHF).Methods A total of 60 patients who met the diagnostic criteria for CHF were divided into observation group(odd number) and control group(even number) according to admission order, with 30 cases in each group. The control group was treated with enalapril maleate tablets, furosemide, spironolactone, and digoxin, and the observation group was treated with furosemide, spironolactone, digoxin and losartan potassium and hydrochlorothiazide tablets. The brain natriuretic peptide(BNP), left ventricular ejection fraction(LVEF) and Minnesota satisfaction questionnaire score of the two groups were compared on the day of admission, 14 d after treatment, and 90 d after discharge. Results On the day of admission, there was no statistically significant difference in BNP,LVEF and physical strenth dimension, emotional dimension and total dimension scores between the two groups(P>0.05). 14 d after treatment, the BNP(402.85±62.58) pg/ml, emotional dimension score(5.99±1.92) points and total dimension score(33.68±4.52) points in the observation group were better than(443.27±68.23) pg/ml,(6.78±1.46) points and(37.35±4.93) points in the control group;the BNP(306.31±59.56) pg/ml, LVEF(47.20±2.03) %, physical strenth dimension score(10.72±2.09) points, emotional dimension score(4.08±1.75) points, and total dimension score(25.23±4.39) points at 90 d after discharge in the observation group were better than(341.46±63.22) pg/ml,(43.22±2.76)%,(13.85±2.93) points,(5.75±2.25) points and(33.69±4.55) points in the control group;all differences were statistically significant(P<0.05). The LVEF(42.85±2.85)% and physical strength dimension score(14.68±2.96) points of the observation group were slightly better than(42.09±3.03)% and(15.02±3.14) of the control group at 14 d after treatment, but the differences were not statistically significant(P>0.05). Conclusion Losartan potassium and hydrochlorothiazide tablets can effectively improve the cardiac function of patients with CHF, and together with post-hospital rehabilitation management to guide patients’ in-hospital and post-hospital treatment, effectively improve the quality of life and survival of patients. It has more prominent long-term effect.