两种治疗小儿先天性心脏病并心力衰竭方法的疗效比较

目的：比较观察常规（洋地黄、利尿剂、血管扩张剂）治疗及常规 卡托普利两种方法，治疗先天性心脏病并心衰的疗效。方法：将35例先天性心脏病并心力衰竭患儿随机分成常规治疗组（常规应用洋地黄、利尿剂及血管扩张剂治疗）；卡托普利组（常规治疗基础上加用卡托普利）疗程12周，结果：卡托普利组心功能级数提高明显优于常规治疗组。结论：在常规治疗基础上加卡托普利是治疗先天性心脏病并心力衰竭的适宜方法。     

ACEⅠ制剂与β-受体阻滞剂联合应用治疗慢性心力衰竭的疗效观察

目的探讨慢性充血性心力衰竭(CHF)的治疗中,在常规使用强心及利尿药物的基础上,加用卡托普利及倍他乐克,观察临床疗效.方法慢性充血性心力衰竭患者80例,分为两组,对照组36例,常规给予洋地黄及利尿剂治疗;观察组44例,在常规治疗的基础上加用卡托普利及倍他乐克.结果观察组与对照组的有效率分别为81.8%与61.6%(P＜0.05).结论在用洋地黄及利尿剂的基础上,加用ACE Ⅰ制剂及β-受体阻滞剂治疗慢性心力衰竭效果优于传统治疗方法.     

ACEⅠ制剂与β-受体阻滞剂联合应用治疗慢性心力衰竭的疗效观察

目的探讨慢性充血性心力衰竭(CHF)的治疗中,在常规使用强心及利尿药物的基础上,加用卡托普利及倍他乐克,观察临床疗效.方法慢性充血性心力衰竭患者80例,分为两组,对照组36例,常规给予洋地黄及利尿剂治疗;观察组44例,在常规治疗的基础上加用卡托普利及倍他乐克.结果观察组与对照组的有效率分别为81.8%与61.6%(P＜0.05).结论在用洋地黄及利尿剂的基础上,加用ACE Ⅰ制剂及β-受体阻滞剂治疗慢性心力衰竭效果优于传统治疗方法.     

硝苯吡啶缓释片和卡托普利联合治疗慢性肺心病心力衰竭30例疗效观察

目的:探讨硝苯吡啶缓释片和卡托普利联用对慢性肺源性心脏病心力衰竭的临床疗效。方法:30例患者给予硝苯吡啶缓释片10 mg口服,每日2次;卡托普利12.5 mg口服,每日3次。对照组30例,住院期间采用常规治疗,如吸氧、利尿剂、洋地黄、血管扩张剂和对症治疗。结果:治疗组总有效率93.33%,对照组总有效率73.33%,两组比较差异有显著性(P<0.05)。结论:硝苯吡啶缓释片和卡托普利联用对慢性肺源性心脏病心力衰竭者心功能改善作用显著,二药联用有协同作用,并且卡托普利有助于肺心病病人肺动脉高压的缓解及血管内皮生长因子(VEGF)含量的下降,这对长期控制心衰疗效明显,安全可靠。     

卡托普利治疗老年心脏瓣膜病合并心功能不全30例疗效观察

目的评价卡托普利治疗老年退行性心脏瓣膜病合并慢性心力衰竭及心律失常的临床疗效。方法30例老年退行性心脏瓣膜病合并慢性心力衰竭及心律失常患者随机分为对照组和治疗组。对照组常规治疗,如吸氧、利尿剂、洋地黄、血管扩张剂和对症支持治疗;治疗组在常规治疗基础上,根据病人耐受情况给予卡托普利6.25～37.5mg口服,3个月为1个疗程。疗程结束后比较两组治疗后受损瓣膜以及心功能和心律失常的改善情况。结果两组治疗后心功能及心律失常均有明显改善(P<0.05),治疗组与对照组比较有统计学意义。结论卡托普利治疗老年退性行心脏瓣膜病合并慢性心力衰竭及心律失常疗效明显,安全可靠。     

低剂量肝素在慢性严重心力衰竭中的应用——附46例报告

自从应用血管扩张剂治疗充血性心力衰竭(CHF)以来,其死亡率有所下降,但仍有一些慢性严重心力衰竭的治疗颇感困难。我们曾对46例经洋地黄、利尿剂及血管扩张剂治疗无效的慢性严重心力衰竭患者,在综合治疗的基础上加用低剂量肝素取得满意疗效,现报告如下。     

硝普钠治疗顽固性心力衰竭20例临床观察

顽固性心力衰竭又称难治性心力衰竭，是指充血性心力衰竭经过正规传统治疗，包括卧床休息，控制水钠入量，应用洋地黄、利尿剂及血管扩张剂的治疗，心力衰竭持续性在或加重者。这种心力衰竭可能是心脏病终末期的表现，但其中相当一部分是由于考虑不周，治疗不力或处理不当所致。笔者在常规治疗的基础上，加用了普钠治疗顽固性心力衰竭20例效果满意，现报道如下：     

稳心颗粒对慢性充血性心力衰竭患者心功能的影响

目的:观察稳心颗粒对慢性充血性心力衰竭(CHF)患者心功能的影响。方法:将82例CHF患者随机分为2组,治疗组和对照组各41例。治疗组在对照组常规治疗(根据病情选用洋地黄、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂、β-受体阻滞剂)基础上加服稳心颗粒,连续治疗4周。比较2组临床症状及心功能改善情况。结果:2组临床症状及心功能明显改善,但治疗组疗效明显优于对照组(P<0.05)。结论:在常规治疗CHF基础上加服稳心颗粒,能进一步改善患者的临床疗效及心功能、生活质量,且安全有效。     

倍他乐克治疗扩张型心肌病的疗效观察

目的 :评价倍他乐克治疗扩张型心肌病的疗效。方法 :扩张型心肌病患者 32例 ,随机分成观察组及治疗组 ,观察组按常规使用洋地黄、利尿剂、血管扩张剂和血管紧张素转化酶 (ACE)抑制剂等 ,治疗组在常规治疗基础上加用倍他乐克。结果 :扩张型心肌病在常规治疗的基础上加用倍他乐克治疗后 ,左室舒张末期直径 (L VDd)、左室射血分数(EF)、心率均明显改善。结论 :倍他乐克治疗扩张型心肌病有较好的临床效果     

卡托普利和倍他乐克治疗慢性心衰观察

目的　联用卡托普利及倍他乐克治疗慢性充血性心力衰竭 (CHF)观察疗效。 方法　4 0例CHF患者分为二组 ,对照组 2 0例 ,单纯给予利尿及洋地黄类药物治疗 ;观察组 2 0例 ,在原对照组治疗基础上加用卡托普利及倍他乐克。疗程均为 2周。 结果　观察组与对照组有效率分别为 95 %与 6 5 % (P <0 .0 5 )。 结论　在用利尿剂及洋地黄基础上 ,联用卡托普利与倍他乐克治疗CHF效果优于传统治疗方法     

Enalapril. An update of its pharmacological properties and therapeutic use in congestive heart failure

Enalapril provides significant haemodynamic, symptomatic and clinical improvement when added to maintenance therapy with digitalis and diuretics in patients with congestive heart failure [NYHA (New York Heart Association) classes II to IV]. These effects are not attenuated during long term therapy. More significantly, a clinical study demonstrated that enalapril reduces mortality when added to established therapy in patients with severe congestive heart failure (NYHA class IV) refractory to digitalis, diuretics and other vasodilators. Thus, ACE inhibitors such as enalapril offer a significant advance in the treatment of congestive heart failure. Because these drugs improve symptoms in patients with classes II to IV failure, and reduce mortality in patients with severe heart failure, they should be considered as first choice adjuvant therapy when a vasodilator is needed in addition to conventional treatment with digitalis and diuretics.     

Captopril: an update review of its pharmacological properties and therapeutic efficacy in congestive heart failure

Captopril is the first angiotensin-converting enzyme inhibitor for oral administration. In combination with continued digitalis and diuretic therapy it has been demonstrated to be effective in the management of severe heart failure refractory to optimal digitalis, diuretic and, in many patients, vasodilator treatment. Most studies to date have been open trials of several weeks or months duration, but a number of patients have received continued treatment, with sustained benefit, for up to 1 year or more. A placebo-controlled trial in a limited number of patients with less severe heart failure has confirmed the results of open trials. Captopril administration improves cardiac performance as a result of a reduction in systemic vascular resistance (afterload) and the various determinants of left ventricular filling pressure (preload). Improvements in exercise tolerance and functional classification, with associated reduction of clinical symptomatology, occur with simultaneous decreases in myocardial oxygen consumption. At present, captopril is worthy of a trial in patients refractory to more traditional medical management. Whether it should be considered a 'first-line' agent after failure of optimal digitalis and diuretic therapy, and before instituting other vasodilator therapy, is less clear. In patients with severe or resistant heart failure, a response to captopril is usually accompanied by a general improvement in the quality of life. The effect of captopril treatment on 1- and 2-year survival rates in patients with severe heart failure appears similar to that reported for other vasodilators. Most patients tolerate captopril treatment well, but hypotension, reduced renal function, skin rash, dysgeusia, and neutropenia have been reported.     

New drug approaches to the treatment of heart failure in infants and children

General considerations in planning therapy of heart failure include identification of the cause, rapidity of onset, and the age of the patient. Neonates and young infants with acute onset heart failure frequently develop acidaemia, respiratory compromise or failure, and metabolic derangements such as hypoglycaemia, hypocalcaemia or hypomagnesaemia. These complications require early recognition and urgent therapy. The diagnosis of heart failure in neonates with ductal dependent congenital cardiac lesions (such as coarctation of the aorta, hypoplastic left heart syndrome or pulmonary valve atresia) allows the early institution of alprostadil (prostaglandin E1) therapy to maintain patency of the ductus arteriosus, which stabilises these infants before surgical therapy. Classic therapy for infants with heart failure due to a large left-to-right shunt consists of salt restriction, diuretics and digoxin. If this treatment is inadequate an angiotensin converting enzyme (ACE) inhibitor (e.g. captopril) is added to therapy. The question then arises whether captopril and diuretics should be the initial therapy and digoxin added if this treatment fails. Acute heart failure may occur in the immediate postoperative period after cardiac surgery or may complicate acute overwhelming infections. Therapy consists of volume loading, vasodilator or inotropic agents. Heart failure due to various forms of chronic dilated cardiomyopathy usually responds to treatment with salt restriction, diuretics, digoxin and captopril. Acute deterioration requires treatment with vasodilators and/or inotropic agents. Heart failure in fetuses may occur from sustained supraventricular tachyarrhythmias, and may respond to treatment of the mother with antiarrhythmic agents such as digoxin or procainamide.     

硝酸异山梨酯治疗慢性肺心病心衰的临床观察

目的评价硝酸异山梨酯治疗慢性肺原性心脏病心衰的疗效。方法将64例慢性肺心病心衰患者随机分为2组 ,治疗组32例在常规治疗的基础上加用硝酸异山梨酯静滴(25mgqd或bid ,10d为1疗程) ;对照组32例为常规治疗。结果治疗组总有效率为90.6 % ,对照组总有效率为62.5 %。两组疗效比较差异有显著意义 (P<0.01)。结论硝酸异山梨酯治疗慢性肺心病心衰疗效确定 ,并且可相应减少利尿剂和洋地黄的用量而减少这些药物引起的副作用。     

卡维地洛治疗慢性心力衰竭患者30例的临床观察

目的观察卡维地洛治疗慢性心力衰竭(CHF)患者的临床疗效。方法将60列CHF患者随机分成对照组和治疗组各30例。对照组使用洋地黄、利尿剂、血管紧张素转换酶抑制剂等药物治疗,治疗组在常规治疗的基础上加用卡维地洛,评估治疗前后心功能、超声心动图。结果在常规治疗基础上加用卡维地洛较一般常规治疗在改善心功能及超声心动图方面效果显著。结论卡维地洛治疗慢性心力衰竭有较好的临床疗效。     

卡托普利、倍他乐克联合治疗慢性充血心力衰竭的临床观察

目的　观察卡托普利、倍他乐克联合治疗对慢性充血性心力衰竭 (CHF)病人的心功能、心率、心胸比及左室射血分数 (LVEF)的影响。方法　 62例CHF病人随机分为两组 ,对照组 30例采用地高辛利尿剂、消心痛等治疗 ,治疗组 32例采用倍他乐克、卡托普利、地高辛、利尿剂治疗。治疗 1 2周。结果　治疗组 ,心率减慢、心胸比率缩小 ,LVEF提高 ,与治疗前相比差异有显著意义 (P <0 0 1 )。而对照组治疗后心率减慢 ,心胸比率缩小 ,LVEF提高 ,但与治疗前相比差异无显著意义 (P >0 0 5)。结论　卡托普利、倍他乐克联合治疗CHF ,可明显使病人心率减慢 ,心胸比率缩小 ,LVEF提高     

参麦注射液合用环磷腺苷治疗难治性心力衰竭82例

目的探讨参麦注射液合用环磷腺苷治疗难治性心力衰竭的临床疗效。方法82例难治性心力衰竭患者随机分为对照组和治疗组。对照组常规治疗（吸氧、利尿剂、洋地黄、血管扩张剂、血管紧张素转换酶抑制剂（ACEI）、控制感染和对症支持疗法）。治疗组在常规治疗基础上,参麦注射液40ml加入5％的葡萄糖250ml,环磷腺苷40mg加入5％葡萄糖250ml静脉点滴,2周为1个疗程,比较两组心功能的改善情况。结果治疗组心功能有显著改善（P均〈0．05）,治疗组与对照组比较有明显差异（P〈0．05）。结论参麦注射液合用环磷腺苷治疗难治性心力衰竭疗效明显,安全可靠。     

卡托普利佐治婴幼儿肺炎合并心衰疗效观察

目的：探讨卡托普利（血管紧张素转换酶抑制剂）在婴幼儿肺炎合并心衰的疗效。方法：将婴幼儿肺炎合并心衰29例，按顺序分成治疗组和对照组，两组在相同治疗基础上，治疗组加卡托普利辅佐治疗。结果：治疗组在症状体征消失的时间上，疗效评价上均优于对照组，总疗效上差异有显著性。结论：卡托普左治疗婴幼儿肺炎合并心衰时有显著疗效。     

麦全冬定心先安治疗充血性心力衰竭

目的探讨麦全冬定与心先安联合治疗充血性心力衰竭的临床疗效。方法56例充血性心力衰竭（CHF）患者随机分为对照组和治疗组。对照组常规治疗[吸氧、利尿剂、洋地黄、血管扩张荆、血管紧张素转换酶抑制剂（ACEI）、控制感染和对症支持疗法],治疗组在常规治疗基础上,麦全冬定1．5g加入5％葡萄糖250ml,心先安120mg加入5％葡萄糖250ml静脉点滴。2周为1个疗程。比较两组心功能的改善情况。结果两组治疗后心功能及心脏指数均有显著改善（P〈0．01）,治疗组与对照组比较差异有统计学意义（P〈0．05）。结论麦全冬定与心先安联合应用治疗充血性心力衰竭疗效明显,安全可靠。     

磷酸肌酸钠对充血性心力衰竭患者脑钠肽及心功能影响

目的探讨磷酸肌酸钠治疗对充血性心力衰竭（CHF）患者脑钠素及心功能的影响。方法选择60例充血性心力衰竭患者,随机分为治疗组和对照组各30例,对照组以利尿剂,洋地黄制剂、血管紧张素转换酶抑制剂及硝酸脂类药物作为常规治疗,治疗组在常规治疗基础上给予磷酸肌酸钠治疗,观察治疗前后患者的临床心功能分级,治疗前后做血浆脑钠肽水平及心脏超声心功能指数测定。结果心功能改善率总有效率治疗组83．3％,对照组66．7％,（P〈0．05）,且治疗组心脏左室射血分数（56．75±8．73）,明显优于对照组（45．61±8．92）,P〈0．05。两组治疗后脑钠素浓度均降低,治疗组治疗效果更明显,两组比较有显著差异有统计学意义（P〈0．01）。结论磷酸肌酸钠治疗可降低血浆脑钠素水平,明显改善心功能。