联合使用依那普利与倍他乐克治疗慢性心力衰竭的临床疗效观察
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[摘要]目的 探讨依那普利与倍他乐克联合应用治疗慢性心力衰竭的临床疗效。方法 将我院收治的76例Ⅱ～ Ⅳ级慢性心力衰竭患者随机分为A组和B组，每组38例，两组患者均给予常规抗心衰治疗，A组38例，在基础治疗的基础上给予依那普利10mg/d治疗，B组在基础治疗的基础上给予依那普利10mg/d，倍他乐克6.25mg bid，6d后根据患者情况调整剂量，疗程3个月。观察两组患者治疗前后血压、心率、心功能变化；采用超声学检查患者左心室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室后壁厚度(LVPW)及室间隔厚度(IVS)的变化。结果 治疗后两组患者心率、收缩压、舒张压均有下降，与治疗前相比差异均有统计学意义(P<0.05)，且B组疗效显著优于A组 (P<0.05)；治疗后两组左室内径指标显著下降，LVEF显著增加，与治疗前相比差异均有统计学意义(P<0.05)，B组上述指标改善情况优于A组(P<0.05)；A组及B组患者总有效率分别为73.7%、92.1%，差异有统计学意义(χ2=4.547，P <0.05)，且B组优于A组。结论 依那普利联合倍他乐克治疗慢性心力衰竭能有效地改善患者心功能，预防左心室重构,明显改善预后。
[关键词] 慢性心力衰竭；依那普利；倍他乐克
[中图分类号] R541.6+1[文献标识码] B [文章编号]1673-9701(2011)21-74-02
Effects of the Combination of Enalapril and Metoprolol in the Treatment of Chronic Heart Failure：A Clinical Observation
YANG Xiaoming
The First Breach Hospital of Kashi Region Second People Hospital in Xinjiang Uygur Autonomous Region , Kashi 844002, China
[Abstract] Objective To study the efficiency of the combination of Enalapril and Metoprolol in the treatment of chronic heart failure. Methods Seventy-six cases patients with II ~ IV degree chronnic heart failure were randomly divided into group A and group B of 38 patients in each group,all the patients were given conventional treatment, 38 patients of group A received enalapril 10mg/d, group B were received enalapril 10mg / d combinded with metoprolol 6.25mg two time every day according to patient, treatment for 3 months . Observing the blood pressure, heart rate, cardiac function after treatment ; tested left ventricular ejection fraction(LVEF), left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD), left ventricular posterior wall Thickness (LVPW)and septal thickness (IVS)changes using ultrasonic examinationin. Results After treatment, the heart rate, systolic and diastolic blood pressure decreased(P<0.05)indicators of two groups after treatment significantly decreased, left ventricular, LVEF increased significantly, but theB group, these indicators improvement is better than that in group A(P<0.05). Conclusion Enalapril metoprolol in the treatment ofCHF patients can improve cardiac function and preventleft ventricular remodeling ......
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