厄贝沙坦氢氯噻嗪片联合倍他乐克对慢性心力衰竭患者左室重构的影响

目的探讨慢性心力衰竭（CHF）患者应用厄贝沙坦氢氯噻嗪片（依伦平）和（或）倍他乐克对改善心室重构的作用。方法选取CHF患者90例,随机分为A、B和C组各30例。A组给予依伦平（厄贝沙坦150mg＋氢氯噻嗪12.5mg）1片/d;B组给予倍他乐克50-100mg/d;C组给予依伦平（厄贝沙坦150mg＋氢氯噻嗪12.5mg）1片/d＋倍他乐克50-100mg/d。均服药8周。治疗前后分别测定超声心动图指标左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）和左室射血分数（LVEF）]。结果 3组CHF患者治疗后超声心动图指标比较,差别均有统计学意义（P〈0.01）;3组患者治疗后LVESV、LVEDV均较治疗前减少,LVEF较治疗前均升高,差异有统计学意义（P〈0.05）;C组患者治疗后LVEVS、LVEDV低于A、B组,LVEF高于A、B组,差异有统计学意义（P〈0.05）,A、B组超声心动图指标比较,差异均无统计学意义（P〉0.05）。结论依伦平联合倍他乐克治疗CHF效果明显优化于单用依伦平或倍他乐克治疗,能更有效地改善心室重构。

Effect of irbesartan and hydrochlorothiazide tablets combined metoprolol on left ventricular remodeling with chronic heart failure

Objective To evaluate the effects of irbesartan and hydrochlorothiazide tablets and（ or） metoprolol on the improvement of myocardial remodeling in patients with chronic heart failure（ CHF）. Methods Totally 90 CHF patients were equally randomized into A,B and C group,each of 30 cases. A group： irbesartan and hydrochlorothiazide tablets group（ 1piece /d of Irbesartan and Hydrochlorothiazide tablets for 8 weeks）. B group： metoprolol group（ 50 - 100 mg /d of metoprolol for 8 weeks）. C group： combined group（ 1piece /d of irbesartan and hydrochlorothiazide tablets combined 50 - 100 mg /d of metoprolol for 8 weeks）. The echocardiographic indicators including left ventricular end-systolie volume（ LVESV）,left ventricular end-diaslolic volume（ LVEDV）,and left ventricular ejection fraction（ LVEF） were measured before and after treatment.Results Echocardiographic parameters were significantly different among 3 groups（ P〈0. 05）. In each group,LVESV and LVEDV significantly decreased and LVEF significantly increased after treatment（ P〈0. 05）. Also,LVESV and LVEDV in C group were lower than those in A group and B group,the differences were statistically significant（ P〈0. 05）; on the contrary,LVEF and LVEDV in C group were significantly higher than those in A group and B group（ P〈0. 05）. However,no such difference was noted between A group and B group（ P〉0. 05）. Conclusion Irbesartan and hydrochlorothiazide tablets combined with metoprolol is remarkably superior than irbesartan and hydrochlorothiazide tablets or metoprolol only in treating patients with CHF. The combined therapy can effectively improve myocardial remodeling.