缬沙坦治疗扩张型心肌病临床探究.docVIP

缬沙坦治疗扩张型心肌病临床探究 　【关键词】 缬沙坦 　　摘要：目的：探讨缬沙坦治疗扩张型心肌病(DCM)的疗效和安全性。方法：63例经常规洋地黄，利尿剂，血管扩张剂, 血管紧张素转换酶抑制剂 (ACEI) 类药物治疗效果欠佳的临床诊断扩张型心肌病患者，随机分为 A、B 两组：即A组 (31例,对照组，常规治疗) ；B组（32例，常规治疗加缬沙坦 80 mg/qd，疗程 8 个月），观察各组病人治疗疗效，治疗前后各组心率、血压、 心功能参数即左室射血分数（LVEF）及二尖瓣血流峰速 E/A比值的变化。结果：治疗后B组同常规治疗组A组比较，心率、血压与治疗前比较均明显改善（Plt;0.05），LVEF增加（Plt;0.05），E/A比值增加（Plt;0.05），临床心功能改善1～2级。药物副作用少，患者耐受性好，B组比A组疗效更为显著（Plt;0.05）。结论：缬沙坦治疗DCM的疗效显著，安全可靠。 　　关键词:扩张型心肌病;缬沙坦 　　The Clinical Efficacy of Valsartan in Treating Dilated Cardiomyopathy 　　　Abstract： Objective ： To evaluate the clinical efficacy and safety of valsartan in treating patients with Dilated cardiomyopathy.(DCM). Method: 63 patients with DCM after conventional treatment with used drugs of cardicglycoside ,diuresis and angiotens inconverting enzyme inhibitor medicine were randomly allocated to two groups (A 、B group). A group(31 cases, conventional therapy as control group)，B group (32 cases， conventional therapy with combination of valsartan 80mg/qd, The course of treatment was 8 months). Before and after the treatment, the clinical efficacy and safety、 blood pressure(BP)、heart rate(HR) 、left ventricular ejection fraction(LVEF) and mitral valve peak flow velocity E/A ratio were measured and compared in each group. Result：After 8 month’s treatment, the patients in B group had significant clinical efficacy (New York Heart Association (NYHA) classification improved 1～2 degree) compared with that of A group（Plt;0.05）, the BP、 HR were significantly improved and LVEF、 E/A ratio significantly increased in B group compared with that in the control group（Plt;0.05）， NYHA classification improved significantly in B group with no severe side effect and better endurance. Conclusion：Conventional therapy with combination of valsartan has obvious clinic efficacy in treating DCM. 　　Key words:Dilated cardiomyoathy；Valsartan 　　“扩张型心肌病”是国际医学界公认的难题，一直被定义为“原因不明的心肌疾病”。由于此病具有进展缓慢、隐蔽性强的特点，其早期发现一直是世界性难题。绝大多数患者发现时往往已造成严重心肌损伤，表现为“心脏扩大、心力衰竭和心律失常”等特征。临床对扩张型心肌病并慢性心力衰竭病人，常规应用利尿剂、强心剂、A