长期超大剂量ARB治疗扩张型心肌病合并心力衰竭1例  

Long-term supramaximal-dose angiotensin receptor blocker treatment for dilated cardiomyopathy complicated with heart failure:a case report

作　　者：刘浩林[1] 廉坤[2] 汪钦[3] 谢华宁 陶凌[2] 何鸣镝 周咏琦 何争[2] LIU Haolin;LIAN Kun;WANG Qin;XIE Huaning;TAO Ling;HE Mingdi;ZHOU Yongqi;HE Zheng(Battalion 5,Brigade 1;Department of Cardiology,Xijing Hospital;Pharmacogenomics Teach- ing And Research Section,College of Pharmacy Fourth Military Medical University,Xi＇an,710032,China)

机构地区：[1]第四军医大学学员一旅五营,西安710032 [2]第四军医大学西京医院心血管内科 [3]第四军医大学药学院药物基因组学教研室

出　　处：《临床心血管病杂志》2018年第7期736-738,共3页Journal of Clinical Cardiology

基　　金：国家自然科学基金青年科学基金项目(No:81500272);陕西省科学技术研究发展计划项目(No:2016SF-034)

摘　　要：1病例资料患者,女,38岁,已婚,长期居住于西安。主因间断气促、胸闷、心悸1个月,加重1周入院。患者1个月前因＂受凉＂感活动后气促、胸闷、心悸,无寒战、高热、出汗,无头晕、头痛、胸痛,无腹痛、腹泻,无恶心、呕吐,休息后症状逐渐缓解,未治疗。1周前无明显诱因上述症状加重,夜间不能平卧,无夜间阵发性呼吸困难及双下肢水肿,为求进一步治疗,门诊以＂扩张型心肌病＂收入我科。A 38-year-old female patient who was diagnosed as dilated cardiomyopathy complicated with heart failure after a long term supramaximal-dose angiotensin receptor blocker treatment was reported.On the first day of hospitalization,she was administered valsartan 80 mg/d,metoprolol succinate sustained-release tablets 23.75 mg/d and other related treatments.Her symptoms such as shortness of breath,chest fullness and palpitations alleviated obviously on the second day,we increased the dose of valsartan to 240 mg/d.These symptoms continued to improve on the third hospitalization day,so we continued to increase the dose of valsartan to the target dose and monitored the changes.On the forth day,the dose of valsartan was elevated to 560 mg/d,including valsartan 400 mg/d and valsartan and hydrochlorothiazide tablets 2 pilles/d,and her symptoms disappeared.She was admitted to take medicine out of hospital since the dose of valsartan and other drugs had been adjusted to the target dose and she had no obvious symptoms.

关 键 词：扩张型心肌病 心力衰竭 血管紧张素Ⅱ受体拮抗剂 

分 类 号：R542.2[医药卫生—心血管疾病]