培哚普利联合厄贝沙坦治疗慢性充血性心力衰竭疗效观察

目的探讨培哚普利与厄贝沙坦联合应用治疗慢性充血性心力衰竭的安全性和有效性。方法慢性心力衰竭者随机分为治疗组（48例）和对照组（48例），在心力衰竭常规治疗基础上，治疗组给予培哚普利2-8mg／d＋厄贝沙坦37．5～150mg／d，对照组给予培哚普利2-8mg／d。治疗观察24周后，比较两组患者心功能改善情况，6分钟步行距离，超声心动图指标改变，血钾、尿素氮、肌酐变化及心率、血压变化情况。结果治疗24周后，组内治疗前后6分钟步行距离、左房内径（LA）、左室舒张末期容量（LVEDV）、左室收缩末期容量（LVESV）、左心室射血分数（LVEF）、短轴缩短率（FS）、心排血量（CO）、心排血指数（CI）比较差异有统计学意义（t对照组分别=2．55、2．04、2．98、3．39、2．58、3．24、3．07、3．28，t治疗组分别=2．35、2．14、3．08、3．29、2．56、3．22、3．05、3．18，P均〈0．05）。治疗后两组间6分钟步行距离、LVEDV、LVESV、EF、FS比较差异有统计学意义（t分别=2．88、2．20、3：04、2．75、3．19，P均〈0．05）；两组间心功能改善显效率的差异有统计学意义（X^2=4．85，P〈0．05）；组内治疗前后血钾、尿素氮、肌酐比较差异无统计学意义（t对照组分别=3．41、4．22、3．86，t治疗组分别：3．46、4．38、3．89，P均〉0．05）。结论培哚普利与厄贝沙坦联合治疗慢性充血性心力衰竭优于单用培哚普利，能提高临床疗效而未增加副反应。

Effects of ibesartan plus perindopril on patients with chronic congestive heart failure

Objective To evaluate the safety and efficacy of ibesartan plus perindopril in patients with congestive heart failure （CHF）. Methods Ninety six patients with CHF were randomized to treatment group （n= 48） which received perindopril 2-8mg/d plus ibesartan 37.5-150mg/d or control group （n=48） which received perindopril 2 -8mg/d besides conventional treatment. After twenty four weeks therapy, functional class, echocardiographic variables, blood potassium, urea nitrogen and creatinine were compared between two groups. Results After twenty four weeks therapy, 6-min walk-test,left atrial diameter, end-diastolic volume（EDV） of the left ventricle（LV）, end-systolic volume（ESV）of LV, left ventricular ejection fraction（LVEF）, fraction shortening（FS）, cardiac output（CO） and cardiac index（CI） and heart function improved significantly in two groups（control group： t= 2.55, 2.04, 2.98, 3.39, 2.58, 3.24, 3.07, 3.28; treatment group： t=2.35,2.14,3.08, 3.29, 2.56, 3.22, 3.05, 3.18,P〈 0.05）. However, treatment group had a more significant improvement in 6-min walk-test, LVEDV, LVESV, LVEF and FS than that of controls （t=2.88, 2.20, 3.04, 2,75, 3.19,P〈0.05）. The cardiac function of treatment group improved significantly compared with the controls （X^2=4.85,P〈 0.05）. The differences of blood potassium, urea nitrogen and creatinine before and after treatment in the two groups were not significant （control group： t=3.41, 4.22, 3.86; treatment group： t=3.46, 4.38, 3.89,P〉0.05）. Conclusions The study suggests that perindopril plus ibesartan in the treatment of CHF is safe, and more effective than perindopril alone.