氯沙坦联合卡维地洛治疗老年慢性充血性心力衰竭的临床研究.docVIP

氯沙坦联合卡维地洛治疗老年慢性充血性心力衰竭的临床研究 　　作者：范玉华，王麦生，许荣廷 作者单位：1 255400 山东淄博，淄博齐都医院急诊科(△心内科)2 250012 山东济南，山东大学齐鲁医院急诊科 　　【摘要】目的 观察氯沙坦联合卡维地洛治疗老年慢性充血性心力衰竭的疗效。方法 132例年龄(62±7.9)岁、NYHA心功能分级Ⅱ、Ⅲ级老年充血性心力衰竭(CHF)患者随机分为三组，即氯沙坦联合卡维地洛治疗组44例，氯沙坦治疗组44例和对照组44例，随访180天，以NYHA心功能分级、超声心动图所示左室射血分数(LVFE)、左室收缩末期内径(LVES)、左室舒张末期内径(LVED)，评估治疗效果，并探讨血清脑钠肽(BNP)水平在心力衰竭处理中的价值。结果 180天时联合治疗组较氯沙坦组的心功能分级、LVEF、LVES、LVED、BNP存在统计学意义(P0.05或P0.01);而联合治疗组及氯沙坦组的心功能分级、LVEF、LVES、LVED、BNP较对照组存在统计学意义(P0.05或P0.01)。结论 氯沙坦联合卡维地洛治疗老年慢性心力衰竭比单用氯沙坦有更好的临床疗效，且能很好地提高生活质量。 　　【关键词】 心力衰竭;氯沙坦;卡维地洛;脑钠肽;心功能 　　Clinical study on effect of losartan combined with carvedilol in aged chronic heart failure 　　FAN Yu-hua，WANG Mai-sheng，XU Rong-tin.Emergency Department，Qidu Hospital，Zibo 255400，China 　　[Abstract] Objective To investigate the therapeutic effect of losartan combined with carvedilol in gerontic patient with chronic heart failure (CHF).Methods 132 cases (aged 62±7.9) of CHF Ⅱ、Ⅲ grade with NYHA heart function grade were divided into three group:losartan and carvedilol combination group (n=44)，losartan group (n=44) and control group (n=44).All patients were followed up for 180days，including their heart function，LVEF by echocardiography，LVES，LVED，BNP value in the treatment of chronic heart failure was also investigated.Results After 180 days，there were significant differences between combination group and losartan group in heart function grade，LVEF，LVES，LVED，BNP (P0.05 or P0.01) and there were also significant differences between above tow groups and control group in heart function group grade，LVEF，LVES，LVED，BNP (P0.01).Conclusion Better clinical results are achieved by losartan and carvdilol combination therapy in gerontic patients with chronic heart failure compared to losartan therapy alone.Life quality of patients also improve by the combination therapy. 　　[Key words] heart failure;losartan;carvedilol;B-type natriuretic peptide;heart function 　　慢性心力衰竭(chronic heart failure，CHF)是一种临床综合征，是各种心脏病的终末阶段。随着人群的老龄化，CH