西拉普利及比索洛尔联合治疗慢性心力衰竭临床观察.doc

西拉普利及比索洛尔联合治疗慢性心力衰竭临床观察 　 ; 作者：杨晓春，韩飞玲，巴格那 毕业论文 【关键词】; 血管紧张素转换酶抑制剂；β-受体阻滞剂；心力衰竭；远期预后 毕业论文 ［摘要］; 目的; 观察血管紧张素转换酶抑制剂西拉普利和β-受体阻滞剂比索洛尔联合应用对慢性心力衰竭(CHF)的远期疗效。方法; 共选择CHF患者114例，随机分为对照组56例和治疗组58例。对照组采用传统的常规治疗，即利尿、扩血管、强心；治疗组在此基础上加用西拉普利2.5～5 mg/d和比索洛尔2.5～7.5 mg/d。在治疗前和治疗期满4年时，分别对心功能NYHAⅡ～Ⅲ级的患者做6 min步行试验。结果; 在随访观察的4年期间，对照组和治疗组中因心力衰竭加重再住院率分别为：治疗组24.13%，对照组82.14%，Plt;0.005；病死率分别为：治疗组8.62%，对照组33.93%，Plt;0.01，与治疗前比较，治疗组在4年后心功能NYHA分级及6 min步行距离均有明显改善，Plt;0.001，而对照组无明显改善，甚至有加重趋势。 结论; 西拉普利和比索洛尔联合应用治疗CHF，可以显著改善CHF患者的远期预后。 毕业论文 ; ［关键词］; 血管紧张素转换酶抑制剂；β-受体阻滞剂；心力衰竭；远期预后 毕业论文 ; Clinical observation on cilazapril and bisoprolol therapy for chronic heart failure 毕业论文 ［Abstract］; Objective; To investigate the longterm effect of angiotensinconverting enzyme inhibitors cilazapril and beta adrenergic receptor bisoprolol win treatment of chronic heart failure(CHF).Methods; 114 patients were divided into the control group (n=56) and the treatment group (n=58) randomly.The general therapy was given to the control group.Besides this therapy,cilazapril (2.5～5 mg/d) and bisprolol (2.5～7.5 mg/d) was to the treatment group.The 6min walk test performed in the CHF patients with NYHA class Ⅱ-Ⅲ prior to and at the end of 4year treatment. Results; The rehospitalization rate was 24.13% in the control group and 82.14% in the treatment group (Plt;0.005).The mortality rate was 8.62% in the control group and 33.93% in the treatment group (Plt;0.01) within 4years.After 4 years,the heart function (NYHA),the 6min walk test improved obviously in the treatment group (Plt;0.001),but did not change significantly in the control group.Conclusion; The longterm prognosis could be improved by cilazapril and bisoprolol in the CHF patients. 毕业论文 ; ［Key words］; angiotensinconverting enzyme inhibitors;beta adrenergic receptor;heart failure;longterm prognosis 毕业论文 ; 近年来的文献报道，将血管紧张素转换酶抑制剂(ACEI)作为慢性心力衰竭(CHF)治疗的基石，但与β-受体阻滞剂合用治疗心衰应用较少，笔者于1995年始选择门诊及住院的CHF患者58例，应用西拉普利与比索洛尔治疗，发现可以明显改善CHF患者的心功能，降低再住院率及病死率，提高CHF患者