替米沙坦联合卡维地洛治疗慢性充血性心力衰竭的的疗效观察.docVIP

替米沙坦联合卡维地洛治疗慢性充血性心力衰竭的的疗效观察 　　[摘要] 目的 研究替米沙坦联合卡维地洛治疗慢性充血性心力衰竭的临床疗效。 方法 选择2010年12月～2013年12月来我院就诊的CHF患者80例。根据治疗方法不同分为观察组（替米沙坦联合卡维地洛治疗）和对照组（替米沙坦治疗），每组各40例，比较两组的疗效及两组患者治疗前后的左室收缩末内径（LVESd），左室舒张末内径（LVEDd），左室射血分数（LVEF）。 结果 观察组的总有效率达95.0%， 对照组的总有效率为77.5%，观察组的疗效明显优于对照组（P0.05）。治疗后，观察组患者LVEDd、LVESd均较对照组显著降低，观察组患者LVEF均较对照组明显升高（P0.05）。 结论 替米沙坦联合卡维地洛治疗慢性充血性心力衰竭疗效确切，可以明显改善患者的心功能，值得推广和应用。 　　[关键词] 慢性充血性心力衰竭；替米沙坦；卡维地洛 　　[中图分类号] R541.6 [文献标识码] B [文章编号] 2095-0616（2014）10-83-03 　　[Abstract] Objective To investigate the clinical efficacy of telmisartan combined with carvedilol in treatment of chronic congestive heart failure. Methods Selected 80 patients with CHF in our hospital from December 2010 to December 2013，were divided into two groups （telmisartan combined with carvedilol therapy） and control group （telmisartan） according to the different treatment methods，each group had 40 cases，the efficacy and LVESd， LVEDd，LVEF were compared before and after treatment between two groups. Results After treatment，the total effective rate of the observation group was 95.0%，the total effective rate of the control group was 77.5%，the efficacy of the observation group was significantly better than the control group （P0.05）.After treatment，the LVEDd，LVESd of the observation group were significantly lower than the control group，the LVEF of the observation group was significantly higher than the control group （P0.05）. Conclusion Telmisartan combined with carvedilol in treatment of chronic congestive heart failure have good efficacy，can significantly improve the heart function of CHF patients，should be promoted and applied. 　　[Key words] Chronic congestive heart failure；Telmisartan；Carvedilol 　　慢性充血性心力衰竭（chronic heart failure，CHF）是一种严重的循环障碍综合征，主要出现在器质性心脏病的终末期。研究表明，肾素-血管紧张素系统（RAS）的激活在慢性充血性心力衰竭的发生、发展中发挥重要的作用[1]。因此，抑制RAS尤其是血管紧张素Ⅱ（AngⅡ）是治疗心力衰竭的主要手段。替米沙坦是一种新型长效的血管紧张肽受体拮抗药，通过阻断Ang Ⅱ与AT1受体的结合而发挥扩张血管、对抗细胞凋亡，抗血栓的作用，从而使心脏负荷减轻，血压下降，有利于治疗CHF[2]。本研究旨在探讨替米沙坦联合卡维地洛治疗慢性充血性心力衰竭的疗效，现报道如下。 　　1 资料与方法 　　1.1 一般资料