坎地沙坦酯联合氢氯噻嗪治疗老年性退行性心瓣膜病心力衰竭的临床观察  

Clinical Observation of Candesartan Cilexetil Combined with Hydrochlorothiazide in the Treatment of Elderly Degenerative Valvular Heart Disease Heart Failure

作　　者：孙在茂 

机构地区：[1]四川剑阁县人民医院内一科,四川剑阁628300

出　　处：《中国药房》2015年第21期2922-2924,共3页China Pharmacy

摘　　要：目的:观察坎地沙坦酯联合氢氯噻嗪治疗老年性退行性心瓣膜病心力衰竭的临床疗效和安全性。方法:120例老年性退行性心瓣膜病心力衰竭患者随机均分为观察组、对照1组、对照2组。所有患者均给予限制活动量、限盐、限水,加用洋地黄类、硝酸盐类强心药等常规治疗。在此基础上,观察组患者给予坎地沙坦酯分散片4 mg,口服,每日1次+氢氯噻嗪片25 mg,口服,每日1次,连用10 d停2 d;对照1组患者给予马来酸依那普利片10 mg,口服,每日1次+氢氯噻嗪;对照2组患者给予酒石酸美托洛尔缓释片50 mg,口服,每日2次+氢氯噻嗪。各组患者均治疗1年后评价疗效。观察各组患者治疗前后血浆脑利钠肽(BNP)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、每搏输出量(SV),用药依从性及不良反应发生情况。结果:各组患者总有效率比较,差异无统计学意义(P>0.05)。治疗后BNP、LVEDD均显著低于同组治疗前,LVEF、SV均显著高于同组治疗前,差异均有统计学意义(P<0.05)。观察组患者用药依从率显著高于对照1组和对照2组,不良反应发生率显著低于对照1组和对照2组,差异均有统计学意义(P<0.05);但对照1组和对照2组两组间比较差异无统计学意义(P>0.05)。结论:在常规治疗的基础上,坎地沙坦酯联合氢氯噻嗪治疗老年性退行性心瓣膜病心力衰竭的临床疗效和安全性均较好。OBJECTIVE：To observe the clinical efficacy and safety of candesartan cilexetil combined with hydrochlorothiazide in the treatment of elderly degenerative valvular heart disease heart failure. METHODS：120 patients with elderly degenerative valvular heart disease heart failure were randomly divided into observation group,control group 1 and control group 2. All patients were given conventional treatment,including limited activity,limited salt,limited water,additional use of digitalis and nitrates cardiac drugs,etc. On this basis,observation group was orally treated with Candesartan cilexetil dispersible tablet 4 mg,once a day＋Hydrochlorothiazide tablet 25 mg,once a day,took 10 d then stopped 2 d;control group 1 was orally treated with Enalapril maleate tablet 10 mg,once a day＋Hydrochlorothiazide tablet;control group 2 was orally treated with Metoprolol tartrate tablets 50 mg,twice a day＋Hydrochlorothiazide tablet. All efficacies of patients were evaluated after one year,and the BNP,LVEF,LVEDD and SV before and after treatment,medication compliance and incidence of adverse reactions were observed. RESULTS：There was no significant difference in the total effective rate in each group（P〉0.05）. After treatment,the BNP and LVEDD were significantly lower than before,LVEF and SV were significantly higher than before,with significant difference（P〈0.05）. The medication compliance in observation group was significantly higher than control group 1 and control group 2,incidence of adverse reactions was significantly lower than control group 1 and control group 2 with significant differences（P〈0.05）;however,there was no significant difference between control group 1 and control group 2（P〉0.05）. CONCLUSIONS：Based on the conventional treatment,candesartan cilexetil combined with hydrochlorothiazide has good clinical efficacy and safety in the treatment of elderly degenerative valvular heart disease heart failure.

关 键 词：心力衰竭 坎地沙坦酯 氢氯噻嗪 疗效 安全性 

分 类 号：R541.6[医药卫生—心血管疾病]