厄贝沙坦对伴左束支阻滞心力衰竭患者的疗效观察

目的观察常规抗心力衰竭药物和血管紧张素Ⅱ受体拮抗剂厄贝沙坦，对21例伴完全性左束支阻滞的充血性心力衰竭患者心功能影响情况，以积累治疗经验。方法将21例严重充血性心力衰竭（EF〈35％）伴完全性左束支阻滞（LBBB）的患者分为对照组和观察组。对照组10例常规予口服螺内酯、氢氯塞嗪或呋塞咪、单硝酸异山梨酯及依那普利、美托洛尔治疗，观察组11例在使用上述药物基础上，加厄贝沙坦150mg，1次／d口服。进行治疗前后比较。结果两组患者心功能情况均有改善，6min步行试验结果较用药前差异有统计学意义（P〈0．05），左室EF值均有所增加（P〈0．05），其中观察组增加更多，但两组间差异无统计学意义（P〉0．05）。结论常规治疗心力衰竭的药物组合能够改善伴左束支阻滞的严重心力衰竭患者的心功能，提高左室EF值和对活动的耐受性，但加用厄贝沙坦并未能显著提高左室EF值。

The effecting of conventional drugs and irbesartan on patients with heart failure and left bundle branch block

Objective The research was used to observed the influence of angiotensin U type receptor-blocker irbesartan to heart function of patients with congestive heart failure and left bundle branch block （LBBB）. Methods 21 cases of serious congestive heart failure （ left ventricular ejection factor, EF 〈 35% ） accompaning with LBBB were divided into control group （11 cases） and test group（ 10 cases）. The control group were treated about three months by diuretics, isosorbide mononitrate and enalapril combining metoprolol , the test group plus irbesartan（ 150 mg, qd） in addition. All of the patients, the left ventricular end-diastolic dimension（LVDED） and EF was detected by color Doppler ultrasound and the exercise tolerance was detected by 6 minutes walking test. after treatment. Results The patients＇ heart function and exercise tolerance of both groups are improved and have significant deviation （P 〈 0. 05 ）. when compared with the condition pre-therapy, however, left ventricular EF has no significant deviation between control and test groups （P 〉 0. 05 ）. Results Ours data suggested that conventional drugs may improve heart function , left ventricular EF and exercise tolera- tion of patients with congestive heart failure and LBBB, but no more effective results was found when combining irbesartan.