两种AT_1拮抗剂治疗重症充血性心力衰竭患者的临床研究  

The Clinical Study of Two Types of Angiotension Receptor Blockers AT_1 Antagonists in Treatment of the Patients with Severe Congestive Heart Failure

作　　者：曾群英[1] 高修仁[1] 廖新学[1] 许庆[1] 郑东诞[1] 王强[1] 陶军[1] 陈国伟[1] 

机构地区：[1]中山大学附属第一医院心内科,广州510080

出　　处：《中国医药导刊》2003年第6期443-445,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨2种血管紧张素Ⅱ受体AT_1亚型阻滞剂(ARB)厄贝沙坦和缬纱坦治疗重症充血性心力衰竭(CHF)的临床疗效,防治心脑血管事件,减少再住院率及不良反应差异。方法:将97例NYHA心功能Ⅲ、Ⅳ级的重症CHF患者随机、单盲分为厄贝沙坦组(49例)、缬沙坦组(48例),比较2组治疗后6个月及2年的临床疗效、临床症状和体征改善、心功能改善、心脑血管事件发生率,再住院率及不良反应情况。结果:2组治疗后6个月、2年的患者临床心功能改善的显效率和总有效率均明显、改善临床主要症状和体征亦显著,左心室收缩及舒张功能改善明显,但上述指标,2组的治疗后组间比较,P>0.05。2组治疗6个月和2年期间,预防发生心脑事件,再住院率减少,降低心脏性死亡等,2组作用相似,P>0.05。2组药物不良反应轻微,且出现率相似。结论:厄贝沙坦和缬沙坦治疗重症CHF患者临床效果佳,减少心脑血管事件,减少再住院率及死亡率均相似,且不良反应均轻微,均可做为治疗重症CHF的新药物之一。Objective: To evaluate the effective role of two types of angiotension receptor blockers AT, antagonist (irbesartan and valsartan) in treatment of the patients with severe congestive heart failure and to observe their benefits in preventing cardiocerebral vascular events, declining re-hospitalization incidence as well as their side effects. Methods: 97 patients with severe congestive heart failure (New York Heart Association, NYHA heart function was Ⅲ and Ⅳ class) were divided into two groups by means of random and single-blind: group one with 49 patients treated by irbesartan and group two with 48 patients treated by valsartan. The clinical symptoms, physical signs and heart function as well as the incidence of cardiocerebral vascular events and re-hospitalization were compared before and after 6 months and two years treatment in two groups. Results:The results showed that the clinical effects were improved remarkably in two groups with different AT1 antagonist treatment after 6 months and two years. The clinical symptoms, physical signs left ventricular eject fraction (LVEF), left ventricular fractional shortening of minor-semi axis (FS), the ratio between peak flow velocity of diastole and a-trial contraction (E/A) were improved after treatment with AT1 antagonist but there were no significant different in two groups respectively. The incidence of cardiocerebral vascular events, re- hospitalization as well as cardiac sudden deaths were lower in two groups after AT1 antagonist treatment, but there were no significant different in two groups also. The side effects of two drugs resembled in two groups and it appeared mildly. Conclusion: There are better clinical effects in treatment with irbesartan and valsartan, a kind of AT1 antagonist, in patients with severe congestive heart failure. The incidence of cardiocerebral vascular and re-hospitalization and cardiac sudden death decline after the two drugs treatment, but there are no significant different in two groups. It is recommended that irbesartan and valsa

关 键 词：AT1拮抗剂 治疗 充血性心力衰竭 ARB CHF 厄贝沙坦 医学 

分 类 号：R541.6[医药卫生—心血管疾病]