依那普利联合卡维地洛对慢性心力衰竭患者心功能、神经内分泌功能及血管内皮功能的影响研究  

Impact of Enalapril Combined With Carvedilol on Cardiac Function,Neuroendocrine Function and Vascular Endothelial Function of Patients With Chronic Heart Failure

作　　者：赵世明 

机构地区：[1]河南省平顶山市第二人民医院心血管4病区,467000

出　　处：《实用心脑肺血管病杂志》2016年第3期19-22,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨依那普利联合卡维地洛对慢性心力衰竭(CHF)患者心功能、神经内分泌功能及血管内皮功能的影响。方法选取2012年3月—2013年3月平顶山市第二人民医院收治的CHF患者94例,随机分为治疗组和对照组,各47例。对照组患者在常规治疗基础上采用依那普利治疗,治疗组患者在常规治疗基础上给予依那普利联合卡维地洛治疗,3个月为1个疗程,共治疗2个疗程。比较两组患者临床疗效,治疗前后心功能、神经内分泌功能及血管内皮功能指标,观察两组患者治疗期间药物不良反应发生情况。结果治疗组患者临床疗效优于对照组(u=2.546,P<0.05)。治疗前两组患者左心室舒张末期内径、左心室收缩末期内径、左心房内径、左心室射血分数及左心室短轴缩短率比较,差异无统计学意义(P>0.05);治疗后治疗组患者左心室舒张末期内径、左心室收缩末期内径及左心房内径小于对照组,左心室射血分数和左心室短轴缩短率高于对照组(P<0.05)。治疗前两组患者血浆肾素活性、血管紧张素Ⅱ及醛固酮水平比较,差异无统计学意义(P>0.05);治疗后治疗组患者血浆肾素活性、血管紧张素Ⅱ及醛固酮水平低于对照组(P<0.05)。治疗前两组患者充血后肱动脉内径、含服硝酸甘油后肱动脉内径、反应性充血后肱动脉内径变化率及含服硝酸甘油后肱动脉内径变化率比较,差异无统计学意义(P>0.05);治疗后治疗组患充血后肱动脉内径、含服硝酸甘油后肱动脉内径、反应性充血后肱动脉内径变化率及含服硝酸甘油后肱动脉内径变化率大于对照组(P<0.05)。治疗期间对照组患者不良反应发生率为6.4%,与治疗组的8.5%比较,差异无统计学意义(P>0.05)。结论依那普利联合卡维地洛能有效改善CHF患者心功能、神经内分泌功能及血管内皮功能,从而提高临床疗效,且安全性较高。Objective To investigate the impact of enalapril combined with carvedilol on cardiac function,neuroendocrine function and vascular endothelial function of patients with chronic heart failure. Methods A total of 94 patients with chronic heart failure were selected in the Second People’ s Hospital of Pingdingshan from March 2012 to March 2013,and they were randomly divided into control group and treatment group,each of 47 cases. Patients of both groups received conventional treatment after admission,and patients of control group were given extra enalapril,while patients of treatment group were given enalapril combined with carvedilol; both groups treated for 2 courses（ 3 months as a course）. Clinical effect,index of cardiac function,neuroendocrine function and vascular endothelial function before and after treatment were compared between the two groups,and incidence of adverse reactions during treatment was observed. Results The clinical effect of treatment group was statistically significantly better than that of control group（ u = 2. 546, P 〈 0. 05）. No statistically significant differences of LVEDD,LVESD,LAD,LVEF or LVFS was found between the two groups before treatment（ P 〉 0. 05）; after treatment,LVEDD,LVESD,LAD of treatment group were statistically significantly smaller than those of control group,while LVEF and LVFS of treatment group were statistically significantly higher than those of control group（ P 〈 0. 05）. No statistically significant differences of renin activity,Angiotensin Ⅱ or aldosterone was found between the two groups before treatment（ P 〉 0. 05）,while renin activity,Angiotensin Ⅱ and aldosterone of treatment group were statistically significantly lower than those of control group after treatment（ P 〈 0. 05）. No statistically significant differences of brachial artery diameter after congestion or taking nitroglycerinr,the change rate of brachial artery diameter after reactive congestion or taking nitroglycerinr was found between the two groups before tre

关 键 词：心力衰竭 卡维地洛 依那普利 神经内分泌系统 内皮 血管 

分 类 号：R541.6[医药卫生—心血管疾病]