替米沙坦与福辛普利治疗充血性心力衰竭的比较

目的比较替米沙坦与福辛普利治疗充血性心力衰竭的临床疗效，并评估其近期治疗的安全性。方法对60例充血性心力衰竭患者（NYHA分级Ⅱ-Ⅲ级）随机分为2组，在常规抗心力衰竭治疗的基础上，根据患者血压情况，一组加用替米沙坦80mg／d；另一组加用福辛普利10mg／d，随访4周，分别监测患者的左室舒张末期内径（LVD）、左室收缩末期内径（LVS）、左室射血分数（LVEF％）和运动耐量。结果①替米沙坦组总有效率83．3％，福辛普利组总有效率70．0％（P〉0．05），差异无统计学意义；②2组治疗后运动耐量6min内所能步行的最大距离均有明显增加，差异无统计学意义；③超声心动图心功能检查，提示对收缩功能改善较福辛普利组明显；④替米沙坦组30例全部完成观察期；福辛普利组有4例因不良反应被迫停药，改用替米沙坦而完成治疗。结论替米沙坦与福辛普利治疗充血性心力衰竭具有相似疗效，前者对收缩功能不全的改善更优，且副反应小。依从性高，适宜长期应用。

Comparison of Telmisartan and Fosinopril in the treatment of congestive heart failure

Objective To compare the clinical efficiency and safety of Telmisartan and Fosinopril on CHF. Methods 60 patients in hospital with CHFNYHA Ⅱ-Ⅲ were divided into 2 groups and they were treated with Fosinopril or Telmisartan combined with basic treatment of heart failure according to the blood pressure. In 4 weeks, the LVD,L-end systolic diameter （LVS）,L-ejection fraction （LVEF%）and exercise tolerance of patients were detected. Results （1）The total effective rate of the Telmisartan group was 86 6% and In the Fosinopril group was 70%（P〉0.05 ）. （2）The exercise tolerance after treatment increased both groups and there was no difference （P〉0.05）. （3）The heart contractile function in Telmisartan group improved better than in Fosinopril group. （4）30 cases in Telmisartan group accomplished test and there were 4 patients in Fosinopril group turned into Telmisartan group because of adverse effect. Conclusion Both of the drugs have similar effect in the treatment of CHF. However, Telmisartan has better effect on contractile function, less adverse effective and compliance than Fosinopril.