氯沙坦治疗高血压所致充血性心力衰竭的临床价值  

Losartan Treatment for Hypertension Induced Congestive Heart Failure

作　　者：敬慧智[1] 吕云霞[2] 闫西艴[3] 刘进 金宏一[5] 孙琳[5] 

机构地区：[1]郑州铁路局中心医院干五病区,河南郑州450052 [2]漯河市中心医院心内科,河南漯河462000 [3]郑州大学一附院心内科,河南郑州450003 [4]信阳市中心医院心内科,河南信阳464000 [5]河南省人民医院心内科,河南郑州450003

出　　处：《高血压杂志》2005年第9期545-548,共4页Chinese Journal of Hypertension

摘　　要：目的探讨氯沙坦治疗高血压所致慢性充血性心力衰竭(CHF)的临床价值.方法采用随机、单盲自身对照及组间对照,将72例高血压CHF患者分为氯沙坦组(36例),服氯沙坦25～100 mg/d,常规治疗组(对照组36例),疗程均为12周,观察两组治疗前后临床疗效,左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、心胸比及实验室参数的变化.结果治疗后氯沙坦组显效率39%(14/36),有效率53%(19/36),无效率8%(3/36);对照组分别为28%(10/36),50%(18/36),22%(8/36),两组LVEDV、血压、心胸比相关参数治疗后与治疗前相比有显著改善(P<0.05,P<0.01),治疗后LVEF[(41.5%±7.2%)比(36.1%±9.3%)(P<0.01)],LVEDV[(130.6±34)mL比(151.3±35)mL(P<0.05)],LVESV[(73.5±30)mL比(88.1±31)mL(P<0.05)],血压[SBP:(102±11)mm Hg比(108±13)mm Hg(P<0.05);DBP:(74±6)mm Hg比(78±9)mm Hg(P<0.05)],心胸比[0.58±0.03比0.63±0.07(P<0.01)]氯沙坦组与对照组组间比较有显著差异,血生化指标两组治疗前后及组间比较均无显著性差异(P>0.05).结论氯沙坦治疗CHF疗效显著,优于常规治疗,值得临床推广应用.Objective To evaluate the efficacy of losartan in treatment of chronic congestive heart failure caused by hypertension. Methods Seventy two patients with CHF were randomly assigned to receive losartan （n =36} 25-100 mg [average dose （50±15）mg] orally QD, or the conventional treatment group（n=36} for a 12 weeks. The changes in the clinical symptoms and signs, BP, HR, left ventricular end diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV）, left ventricular ejection fraction （LVEF）, cardio thoracic ratio and laboratory parameters were determined before and after the treatment. Results After the treatment, the significant effective rate was 39%（14/36）, the effective rate was 53% （19/36）, the non response rate was 8% （3/36} in the losartan group compared with the control group of 28% （ 10/36） , 50% （ 18/36 ） , 22% （8/36 ） respectively. After treatment, LVEDV, BP, cardio-thoracic ratio were improved in both groups. However, significant differences were found between the losartan group and the control group in LVEF（41.5%±7.2%） vs （36. 1%±9.3%） （P〈0.01 ） , LVEDV[（130.6±34）mL vs. （151.3±35）mL （P〈0.01）], LVESV[（73.5±30 ）mL vs （88.1±31）mL （P〈0.05）], BP[SBP：（102±11）mm Hg vs （108±13）ram Hg（P〈0.05） ; DBP： （74±6）mm Hg vs （78±9）ram Hg（P〈0.05）], and the cardio-thoracic ratio[0.58±0.03 vs 0. 63±0. 07 （P〈0.01）]. Conclusion The efficacy of losartan in treatment of CHF is satisfactory and prevail over the conventional treat ment.

关 键 词：氯沙坦 充血性心力衰竭 高血压病 RAS 慢性充血性心力衰竭 临床价值 高血压 治疗组 左室收缩末期容积 左室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病] R544.1[医药卫生—内科学]