伊贝沙坦与贝那普利治疗老年慢性心力衰竭疗效的比较

目的　比较伊贝沙坦与贝那普利治疗老年慢性心力衰竭 (CHF)的临床疗效及安全性。方法　 6 2例老年CHF患者在常规治疗基础上随机分为两组。伊贝沙坦组 (31例 )用伊贝沙坦 30 0mg d ;贝那普利组 (31例 )用贝那普利 2 0mg d。疗程为 2 0周。结果　伊贝沙坦组治疗后临床显效率 4 1.94 % ,有效率 5 4 .84 % ,无效率 3.2 2 % ;贝那普利组分别为 4 0 .0 0 %、5 6 .6 7%、3.33%。与治疗前比较 ,两组在左心室质量指数、左心室射血分数、左心室舒张末期内径、左心室收缩末期内径等相关参数均有显著改善 ;血压有所下降 ,血钾略有升高 ,但均在正常范围内 ,血肌酐无明显变化 ;两组各有 1例因心力衰竭恶化而再次住院 ,无 1例死亡 ,存活率 10 0 % ;除刺激性干咳、首剂低血压反应发生率伊贝沙坦组明显低于贝那普利组外 ,组间比较差异均无显著性意义。结论　伊贝沙坦治疗老年CHF与贝那普利疗效相似 ,且耐受性、安全性更高 ,对老年CHF患者更有益。可作为老年CHF患者不能耐受血管紧张素转换酶抑制剂的优先选择。

The comparison of efficacy of irbesartan and benazepril in the treatment of elderly patients with chronic heart failure

Objective To compare the clinical efficacy and safety of irbesartan with those of benazepril in the treatment of elderly patients with congestive heart failure (CHF).Methods On the basis of conventional treatments, 62 elderly patients with CHF were randomly divided into two groups: irbesartan group (n=31) was treated with irbesartan 300 mg per day and benazepril group (n=31) with benazepril 20 mg per day. The course of treatment was 20 weeks.Results After treatment, the cardiac function, LVMI, LVEF, LVEDd and LVESd were markedly improved in both groups, but not statistically different between the two groups. Although blood pressure decreased significantly and serum potassium increased slightly, both of them were in normal range. During the treatment,one patient was rehospitalized because of deterioration of cardiac function in each group and no death in both group. Irbesartan was well tolerated and caused lower incidence of cough and first-dose hypotension effect as compared with benazepril.Conclusions Irbesartan and benazepril have similar efficacy in the treatment of the elderly CHF patients, but irbesartan is more tolerable and reliable than benazepril. Irbesartan is more suitable for the elderly CHF patients and may be used as a first alternative in patients intolerant to ACEI.