联合用药治疗心衰患者的临床研究  

Effects of Benazepril alone or in combination with Valsartan in heart failure patients in six months and two years

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,江苏226001 [2]苏州大学第一附属医院,江苏215006

出　　处：《常州实用医学》2008年第5期281-284,共4页CHANGZHOU PRACTICAL MEDICINE

摘　　要：目的 观察苯那普利及其合用缬沙坦治疗半年及两年对血浆NE、AngⅡ、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衰治疗中的临床价值。方法（1）61例慢性心衰患者随机分为苯那普利治疗组（30例）和苯那普利合用缬沙坦组（31例）；（2）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、治疗半年及两年后血浆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、治疗半年及两年后左室射血分数（LVEF），同时观察两年内两组患者的再住院率。结果（1）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；（2）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；（3）组问对比发现，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，治疗半年与两年后的结果相比无明显改变。（4）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（1）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。（2）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 By detecting the changes of and the correlation between blood Norepinephrine（NE） .Angiotensin Ⅱ （AngⅡ ）.Aldostemne（ALD）, Left ventricular ejection fraction（LVEF）and rate of hospitalization, We studied the effects and explored the clinical vaule of Benazepril alone or in combination with Valsartan despite standard therapy in Chronic heart failure patients with different cause and different New York Heart Associafion（NYHA） heart function classes in six months and two years. Methods 1,We enrolled 61 patients with chronic heart failure. The patients were randomly assigned to receive Benazepril alone （30 patients ）or in combination with Valsartan（ 31 patients ）in addition to standard therapy for a total six months. 2, Plasma levels of Norepinephrine（NE）was measured by enzyme - linked immynosorbent assay（ ELISA）, Anglotensin Ⅱ（ AngⅡ） and Aldosterone （ALD）were measured by mdioimmunoassay, Doppler echocardiography was performed to measured parameters of left ventrieular function, before and after 6 months treatment. Results 1.After six months and two years of treatment with Benazepril in addition to standard therapy,plasma level of NE was significantly decreased and LVEF was significantly increased（ P 〈 0.01 ）,but plasma level of Ang Ⅱ and ALD were not changed obviously. 2,After six months and two years of treatment with Benazepril in combination with Valsartan in addition to standard therapy, plasma level of NE and ALD was significantly decreased（ P 〈 0.01 ）and LVEF was sighifieandy increased（ P 〈 0.01 ） ,but plasma level of AngⅡ were not changed obviously.3,By studied between- group difference of two groups,we find that Benazepril in combination with Valsartan could enhance LVEF（ P 〈 0.01）and reduce the plasma level of NE,AngⅡ ,ALD（ P 〈 0.05 - 0.01 ）more effectively.4,Benazepril in combination widl Valsartan could reduce rate of hospitalization more effectively（ P 〈 0.05）. Conclusion 1 ,Benazepril could reduce the pl

关 键 词：慢性心力衰竭 去甲肾上腺素 血管紧张素Ⅱ 醛固酮 左室射血分数 再住院率 彩 色多普勒超声 苯那普利 缬沙坦 

分 类 号：R972.4[医药卫生—药品] R541.6[医药卫生—药学]