苯那普利及其合用缬沙坦治疗心力衰竭患者半年及2年的临床观察  

Effects of benazepril alone or in combination with Valsartan on heart failure in 6 months and 2 years of treatment

作　　者：金恒[1] 吴红萍[1] 华守明[1] 刘志华[2] 

机构地区：[1]南通市第一人民医院心内科,江苏南通226001 [2]苏州大学第一附属医院心内科,江苏苏州215006

出　　处：《南京医科大学学报（自然科学版）》2006年第10期960-963,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:观察苯那普利及其合用缬沙坦治疗半年及2年对血浆去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD),心功能状态和住院率的影响,探讨苯那普利合用缬沙坦在心力衰竭治疗中的临床价值。方法:61例慢性心力衰竭患者随机分为苯那普利治疗组和苯那普利合用缬沙坦组,用同位素放射免疫测定法和酶联免疫吸附法分别测定两组患者治疗前、治疗半年及2年后血浆AngⅡ、ALD和NE水平,用心脏彩色多普勒超声诊断仪测量两组患者治疗前、治疗半年及2年后左室射血分数(LVEF),同时观察2年内两组患者的再住院率。结果:苯那普利治疗后血浆NE水平明显降低(P<0.01),LVEF明显增高(P<0.01),而血浆AngⅡ、ALD水平改变不大;苯那普利加缬沙坦治疗后血浆NE、ALD水平明显降低(P<0.01),LVEF明显增高,而血浆AngⅡ水平改变不大;组间对比发现,苯那普利合用缬沙坦能更有效地降低血中NE、AngⅡ和ALD的水平(P<0.01),提高左室射血分数,改善心功能,治疗半年与2年后的结果相比无明显改变。联合用药组与苯那普利治疗组相比,再住院率明显减少(P<0.05)。结论:苯那普利治疗明显降低血浆NE水平、对AngⅡ和ALD水平的影响不大;苯那普利和缬沙坦联合治疗明显降低血浆NE和ALD水平,对AngⅡ水平的影响不大。两种治疗方法都能提高CHF患者的LVEF,改善心功能;联合用药组在降低NE、AngⅡ、ALD水平及住院率方面明显优于单用苯那普利组。Objective： To explore the effects of benazepril alone or in combination with valsartan on chronic heart failure with different cause and different NYHA（New York Heart Association） heart function classes in six months and two years. Methods：Sixtyone patients with chronic heart failure were encrolled. The patients were randomly assigned to benazepril group （30 patients） or combination treatment group （31 patients） in addition to standard therapy for a total six months. Plasma level of Norepinephrine（NE） was measured by enzyme-linked immunosorhent assay （ELISA）. Angiotellsin Ⅱ （Ang Ⅱ ）and Aldosterone （ALD）were measured bv radioimmunoassay,doppler echocardiography was performed to measure the parameters of left ventrieular function before and 6 months after treatment. Results：Six months and two years after treatment with benazepril in addition to standard therapy, the plasma level of NE was significantly decreased and LVEF was significantly increased （P 〈 0.01 ）, but the plasma levels of Ang Ⅱ and ALD were not changed significantly.After six months and two years of treatment with benazepril in combination with valsartan in addition to standard therapy, the plasma levels of NE and ALD were significantly decreased （P 〈 0.01 ） and LVEF was significantly increased （P 〈 0.01 ）, hut the plasma level of Ang Ⅱ waw not changed obviously. Conclusion： Benazepril in combination with valsartan could enhance LVEF （P 〈 0.01 ） and reduce the plasma level of NE,Ang Ⅱ ,ALD （P 〈 0.05-0.01 ） more effectively.Benazepfil in combination with valsartan could reduce the rate of hospitalization more effectively （P 〈 0.05）.

关 键 词：慢性心力衰竭 苯那普利 缬沙坦 再住院率 左室射血分数 

分 类 号：R541.6[医药卫生—心血管疾病]