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比索洛尔、依那普利和螺内酯联合治疗风湿性心脏病慢性心力衰竭的效果(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第5期
页码:
623-625,628
栏目:
临床研究
出版日期:
2011-10-25

文章信息/Info

Title:
Effect of enalapril, bisoprolol and spironolactone on chronic heart failure caused by rheumatic heart disease
作者:
管一平1; 邹翰琴2
宜宾市第二人民医院：1.心内科，2.超声诊断科，四川 宜宾 644000
Author(s):
GUAN Yi-ping1;  ZOU Han-qin2
1.Department of Cardiology, 2.Ultrasound Department, Yibin Second People’s Hospital, Yibin 644000, Sichuan, China
关键词:
心脏病; 风湿性; 心力衰竭; 慢性; 依那普利; 比索洛尔; 螺内酯; 心脏重构
Keywords:
rheumatic heart disease;  heart failure;  enalapril;  bisoprolol;  spironolactone;  ventricular remodeling
分类号:
R541.61
DOI:
-
文献标识码:
A
摘要:
目的:观察比索洛尔、依那普利和螺内酯联合治疗风湿性心脏病（风心病）慢性心力衰竭（心衰,CHF）对心脏重构的影响。方法： 风心病并发心衰患者86例,随机分为比索洛尔、依那普利和螺内酯联合治疗组（试药组）以及常规治疗方案对照组（对照组）。在治疗后1年测定心功能与左室内径等指标。结果： 试药组左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）显著下降，左室射血分数（LVEF）增加显著，与对照组比较有显著差异（均P<0．05）。结论： 比索洛尔、依那普利和螺内酯联合治疗治疗风心病心力衰竭较常规治疗方法在改善心衰，阻止心脏重构方面效果更好。
Abstract:
AIM:To study the effect of enalapril, bisoprolol and spironolactone on chronic heart failure (CHF) caused by rheumatic heart disease (RHD). METHODS: Eighty six RHD patients with CHF were randomly divided into control group (n=43) and experimental group (n=43). The experimental group was treated with enalapril, bisoprolol and spironolactone, whereas the control group was treated with a conventional regimen. RESULTS: Left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) in the experimental group were significantly lower than in the control group. Left ventricular ejection fraction in the experimental group was much higher (P<0.05). CONCLUSION: Combination therapy of enalapril, bisoprolol and spironolactone has a better effect on patients with CHF caused by RHD and inhibits ventricular remodeling.

参考文献/References

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[2]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.

[3]Chan AK,Sanderson JE,Wang T,et al.Aldosterone receptor antagonist induces reverse remodeling when added to antigenson receptor blockade in chronic heart failure[J].J Am Coll Cardio,2007,50(7):591-596.

[4]Tang WH,Parameswaran AC,Maroo AP,et al. Aldosterone receptor antagonizes in the medical management of chronic heart failure[J].Mayo Clin Proc,2005,80(12):1623-1630.

[5]Zannad F,Alla F,Dousset B,et al.Limitation of excessive extracellular matrix turnover may contribute to survival benefit of spironolactone therapy in patients with congestive heart failure insights from the randomized alactone evaluation study (RALES).Rales Investigators[J].Circulation,2000,102(22):2700-2706.

[6]Hunt SA,Baker DW,Chin MH, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary.A report of the ACC/AHA task force on practice guidelines[J].J Am Collcardio,2001,35(2):101-2113.

[7]Benetos A,Adamopoulos C,Argyriadis P,et al.Clinical results with bisoprolol 2.5 mg/hydrochlorothiazide 6.25 mg combination in systolic hypertension in the elderly[J].J Hypertens Suppl,2002,20(1):S21-S25.

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备注/Memo

备注/Memo:
收稿日期：2010-09-30.作者简介：管一平，副主任医师Email:ybgc831@sina.com
更新日期/Last Update: 2011-11-03