厄贝沙坦与比索洛尔对扩张型心肌病心功能及左室重构的影响  

Effects of ARB and β-biocker in heart function and left ventricular remodeling of Dilated Cardiomyopathy

作　　者：冉瑞明[1] 陈平[1] 史光东[1] 康忠明[1] 邓大河[1] 

机构地区：[1]重庆三峡中心医院平湖分院内科,重庆市404000

出　　处：《中国基层医药》2012年第1期38-39,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察血管紧张素受体拈抗剂（ARB）、β受体阻滞剂单用及联合应用对扩张型心肌病（DCM）的临床疗效。方法将95例DCM患者随机分为ARB组（A组）32例，给予厄贝沙坦150mg，1次／d，无不良反应，渐增量300mg；B受体阻滞剂组（B组）30例，给予比索洛尔1．25mg，1次／d，无不良反应，每1—2周剂量倍增至患者能耐受；ARB和B受体阻滞剂联合组（AB组）33例，以上两药联合应用至患者能耐受的最大剂量。三组均长期维持治疗，疗程12个月。结果A、B、AB三组总有效率分别为84．37％、80．40％、93．93％，AB组与A、B组差异均有统计学意义（x2=4．95、3．95，均P〈0．05），三组治疗后6min步行距离、左室舒张末期内径（LVEDd）、左室收缩末期内径（LVESd）、左室射血分数（LVEF）与治疗前比较，差异均有统计学意义（均P〈0．05），A组与B组差异无统计学意义（P〉0．05），AB组与A组及B组差异均有统计学意义（均P〈0．05）。结论ARB与B受体阻滞剂联合治疗DCM疗效优于单用ARB或p受体阻滞剂，且耐受好。Objective To investigate the effects of ARB or/and β-blecker in treatment of dilated cardiomy-opathy（DCM）. Methods 95 cases with DCM were randomly divided into 3 groups. ARB group（ A,32 cases） was treated with Irbesartan, 150 mg/d without adverse drug reaction and then to 300 mg/d weekly; β-blocker group（ B,30 cases） was treated with Bisoprolol, 1.25 mg/d without adverse drug reaction and then to maximal dose weekly;combi- nation group（ AB,33 cases） Was treated with Irbesartan and Bisoprolol to maximal dose which patients were able to tolerate. The 3 groups were observed for a period of 12 months. Results Comparing with pretreatment, the results of 6 rain walk, LVEDd, LVESd, LVEF were improved significantly（ all P 〈 0.05 ）. There were no significant differences between A group and B group（P 〉0. 05） ,but the differences between combination group and A group or B group were significant（ P 〈 0.05）. Conclusion Effect of ARB combined with β-blocker was better than that of ARB or β-bloc-ker alone in treatment of DCM and well tolerated.

关 键 词：厄贝沙坦 比索洛尔 心肌病 充血性 心力衰竭 左室重构 

分 类 号：R542.2[医药卫生—心血管疾病]