替米沙坦治疗扩张型心肌病并发心功能不全的疗效评价(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2006年第4期
- 页码:
- 427-429
- 栏目:
- 临床研究
- 出版日期:
- 2006-08-25
文章信息/Info
- Title:
- Efficacy evaluation of Telmisartan in treatment of dilated cardiomyopathy with heart failure
- Author(s):
- LI Jing; CHENG He-xiang; JIA Guo-liang; ZHOU Shi-qin
- Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi′an, Shaanxi 710032, China
- 关键词:
- 扩张型心肌病; 替米沙坦; 西拉普利; 血管紧张素Ⅱ受体拮抗剂; 心力衰竭
- Keywords:
- dilated cardiomyopathy; Telmisartan; Cilazapril; angiotension-Ⅱ receptor antagonist; heart failure
- 分类号:
- R542.2
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的 观察替米沙坦（迪赛平）对扩张型心肌病并发心功能不全患者的临床疗效。方法 扩张型心肌病并发心力衰竭患者62例，随机分为替米沙坦组和西拉普利组。在常规强心、利尿等抗心力衰竭治疗的基础上，给予替米沙坦组口服替米沙坦40 mg/d，给予西拉普利组患者口服西拉普利2.5 mg/d，治疗前及治疗后6个月超声心动图观察心脏结构，左心室收缩功能的变化。结果 在治疗6个月期间，与治疗前相比两组患者心功能得到明显改善。替米沙坦组总有效率为84%，西拉普利组为87%。两组心功能改善无显著性差异。使用替米沙坦后6个月左室射血分数，短轴缩短率明显改善，舒张期左室后壁厚度（LVPWT）,舒张期室间隔厚度（IVST）,左心房内径（LA），左室收缩末内径（LVESD），左室舒张末内径（LVEDD）,心胸比例均显著下降(P<0.05)。结论 替米沙坦能显著改善扩张型心肌病患者的左室收缩功能，并逆转心室重构，与血管紧张素转换酶抑制剂（ACEI）同样安全有效，特别是当应用ACEI出现咳嗽等副作用时，可作为理想的替代药物。
- Abstract:
- AIM To observe the efficacy of angiotensionⅡ receptor antagonist (Telmisartan) in the treatment of dilated cardiomyopathy with heart failure. METHODS Sixtytwo patients with dilated cardiomyopathy and heart failure were randomly divided into two groups, both of whom received antiheartfailure treatment by digilalis, diuretics and vasodilators. Group A were given temisartan 40mg orally once a day for 3 months while group B were given angiogenesis converting enzyme inhibitor (ACEI) Cilazapril 2.5 mg orally once a day for 3 months. RESULTS Symptoms were significantly alleviated in both groups compared with those before therapy (P<0.05). There was no significant difference in the total effective rate between two groups (84% vs 87%). After 3 months' treatment, BP and LVEDD decreased significantly (P<0.05), while cardiac function, LVEF, CO and FS increased significantly (P<0.05). Few adverse effects were observed and patients tolerance was good. CONCLUSION Telmisartan is effective in the treatment of dilated cardiomyopathy with heart failure and it is as effective as ACEI in the treatment of dilated cardiaomyopathy with heart failure.
参考文献/References
［1］ 中华医学会心血管分会.慢性收缩性心力衰竭治疗建议［J］.中华心血管病杂志，2002，30（1）：7-23.
［2］ Israili ZH. Clinical pharmacokinetics of angiotensinⅡ(AT1) receptor blockers in hypertension ［J］. J Hum Hypertens,2000,14(Suppl 1):S73-S86.
［3］ Neutel J M，Smith DHG. Does response and antihypertensive efficacy of the AT1 receptor antagonist telmisartan in patiens with mild to moderate hypertension［J］. Adv Ther,1998 , 15(4): 206-217.
［4］ 刘成伟，汪道文，邓又斌，等.替米沙坦逆转原发性高血压心肌肥厚的作用［J］.临床心血管病杂志，2002，18（6）：251-252.
［5］ 占亚平.血管紧张素Ⅱ治疗左心功能不全的疗效观察［J］. 岭南心血管病杂志，2003，9（6）：420-422.
备注/Memo
- 备注/Memo:
- 收稿日期：2005-10-24.作者简介：李景, 住院医生，硕士生 Tel：(029)84775318 Email：Lijing3@fmmu.edu.cn
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