卡维地洛联合贝那普利或氨氯地平治疗慢性充血性心力衰竭临床探究.docVIP

卡维地洛联合贝那普利或氨氯地平治疗慢性充血性心力衰竭临床探究【中图分类号】R961【文献标识码】A【文章编号】1672－3783(2011)08－0365－01 【摘要】目的：评价与比较卡维地洛联合贝那普利或氨氯地平治疗慢性充血性心力衰竭（CHF）的临床疗效。方法：入选198例慢性充血性心力衰竭的患者，随机分为贝那普利组（n=100）和氨氯地平组（n=98），两组患者先经一周安慰剂洗脱，然后贝那普利组的患者起始口服卡维地洛3.125mg，bid和贝那普利2.5mg，qd；氨氯地平组患者起始口服卡维地洛3.125mg,bid和氨氯地平2.5mg,qd；两组患者在服药1周后，根据临床实际调整药物剂量或加用其它药物。记录所有患者入组时和治疗两年后的左室射血分数（LVEF）和左室舒张末期内径（LVEDd），随访两年记录随访期间患者发生的心血管事件（CV）。结果：在LVEF和LVEDd两项指标上，贝那普利组治疗后与入组时比较，均有P＜0.01，治疗后与氨氯地平组比较，有P＜0.05；而氨氯地平组治疗后与入组时比较，均有P＜0.05。贝那普利组患者心血管事件发生率为15.0%，氨氯地平组为27.6%，两组间差异非常显著（P＜0.01），且在心血管事件类型上，两组间差异也非常显著（P＜0.01）。结论：卡维地洛联合贝那普利治疗慢性充血性心力衰竭疗效优于联合氨氯地平，预后较好。 【关键词】卡维地洛 贝那普利 氨氯地平 心力衰竭 心血管事件 左室射血分数 Clinical Study of Carvedilol Combined with Benazepril or amlodipine in the Treatment of Chronic Heart Failure Yang Yongcong 【ABSTRACT】Objective: To evaluate and compare the clinical efficacy of carvedilol combined with benazepril or amlodipine in the Treatment of Chronic Heart Failure (CHF).Methods:198 patients with CHF were divided into 2 groups at random, benazepril group (n=100) and amlodipine group (n=98). At first all the patients took the placebo for one week, and then the patients of benazepril group started to take carvedilol 3.125mg (bid) and benazepril 2.5mg (qd); the patients of amlodipine group began to take carvdiol 3.125md (bid) and amlodipine 2.5mg (qd).After one week, according to the clinical conditions, the drugs were modulated or others were added to the treatment. Recorded the left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDd) of all the patients When choen into the text and after two years follow-up, also the cardiovascular events (CV) incidence during the period including. Results: At the point of LVEF and LVEDd, the benazepril group made obvious difference between after the treatment and the beginning (p 1.3 统计学方法:采用SPSS13.0统计软件包对数据进行分析处理，计量资料结果采用均数±标准差表示，组间采用t检验，计数资料结果采用χ2检验，P＜0.05表示存在显著性差异，P＜0.01表示存在非常显著的差异。? 2 结果 2.1 临床指标比较:根据入组时与随访两年后的数据，两组患者前后LVEF值