不同剂量培哚普利对充血性心力衰竭患者心脏功能的影响

目的:观察不同剂量培哚普利对充血性心力衰竭(CHF)患者心脏功能的影响。方法:135例CHF患者按随机数字表法分为对照组(68例)和观察组(67例)。两组患者均给予利尿药、β受体阻滞药等常规治疗后,对照组患者给予培哚普利,起始剂量为2 mg,根据患者情况每间隔1²周加量2 mg,靶剂量为22周加量2 mg,靶剂量为2⁴ mg/d;观察组患者给予培哚普利,起始剂量为2 mg,根据患者情况每间隔14 mg/d;观察组患者给予培哚普利,起始剂量为2 mg,根据患者情况每间隔1²周加量2 mg,靶剂量为82周加量2 mg,靶剂量为8¹0 mg/d。如果加量过程中出现咳嗽、血压降低时则维持原有剂量。两组患者至靶剂量后均维持治疗6个月。观察两组患者治疗前后6 min步行距离、血浆脑钠肽(BNP)、收缩压(SBP)、舒张压(DBP)、血钾、肌酐、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)和左室射血分数(LVEF)。结果:治疗前两组患者心功能各指标、6 min步行距离、SBP、DBP比较,差异均无统计学意义(P>0.05)。治疗后两组患者LVESD、LVEDD、BNP、SBP、DBP均显著低于同组治疗前,且观察组低于对照组;LVEF、6 min步行距离显著高于同组治疗前,且观察组高于对照组,两组比较差异均有统计学意义(P<0.05)。两组患者治疗前后血钾、肌酐及不良反应发生率比较,差异无统计学意义(P>0.05)。结论:高剂量培哚普利改善CHF患者的心脏功能效果优于常规剂量,安全性较好。

Effects of Different Dose of Perindopril on Cardiac Function in Patients with Congestive Heart Failure

OBJECTIVE： To observe the effects of different dose of perindopril on cardiac function in patients with congestive heart failure （CHF）. METHODS： 135 CHF patients were randomly divided into control group （n=68） and observation group （n= 67）. Both groups were given conventional treatment of diuretics and β-blockers; control group was given perindopril 2 mg firstly, increasing to target dose of 2-4 mg/d by increasing 2mg every 1 or 2 weeks according to the conditions of patients; observation group was given perindopril 2 mg firstly, increasing to target dose of 8-10 mg/d by increasing 2 mg every 1 or 2 weeks according to the conditions of patients. If cough and the reduction of blood pressure appeared in the process of adding amount, the dose maintained original level. Both groups received target dose of drugs after consecutive 6 months. The 6-min walking distance, plasma brain natriuretic peptide （BNP）, SBP, DBP, serum potassium, creatinine, LVESD, LVEDD and LVEF were observed in 2 groups before and after treatment. RESULTS： Before treatment, heart function index, 6-min walking distance, SBP and DBP of both groups had no statistical significance （P〉0.05）. LVESD, LVEDD, BNP, SBP and DBP of both groups after treatment were significantly lower than before, and those of observation group was lower than those of control group; LVEF and 6-min walking distance was significantly higher than before, and those of observation group was higher than those of control group; there was statistical significance （P〈0.05） ; the difference of serum potassium, ereatinine and the incidence of ADR had no significant difference between 2 groups before and after treatment （P〉0.05）. CONCLUSIONS： perindopril can improve cardiac function in patients with congestive heart failure with good security.