厄贝沙坦对风湿性心脏病换瓣术后患者房室重构的作用

目的:探讨厄贝沙坦对风湿性心脏病(RHD)患者换瓣术后心脏形态、容积及功能的影响。方法:50例RHD患者行换瓣术后随机分为对照组和厄贝沙坦组;2组患者在手术后均给予华法林、强心苷、利尿剂等常规治疗;厄贝沙坦组在手术1周后加服厄贝沙坦75～150mg·d-1,疗程为6个月。术后1周、术后6个月经胸超声心动图测量2组患者左、右房室功能和形态的指标。结果:术后6个月,2组与治疗前比较,心脏各腔室均明显缩小,左心室射血分数(LVEF)、右心室射血分数(RVEF)、心脏指数(CI)均明显升高(P<0.05或P<0.01),超声心动图测定的左心室重量指数(LVMI)均明显降低(P<0.05)。厄贝沙坦组经治疗6个月后心脏形态功能和容积各指标较对照组均有明显的改善(P<0.05)。结论:厄贝沙坦能明显改善RHD患者换瓣术后心脏形态、容积及功能。

Effect of Irbesartan on Heart Remodelling in Patients with Rheumatic Heart Disease after Valve Surgery

OBJECTIVE： To evaluate the effects of Irbesartan on cardiac size and its function in patients with rheumatic heart disease （RHD） after valve surgery. METHODS： 50 RHD patients were divided into 2 groups： control group and Irbesartan group. Both groups were given conventional therapy for 6 months. Irbesartan group were additionally treated with Irbesartan （75-150 mg·d^-1）. Ehocardio graphic examinations were performed before and at 6th month after surgery. RESULTS： As compared with before treatment, the atriums and ventricles volume of 2 groups were decreased significantly at 6th month after treatment. The level of LVEF, RVEF, CI of patients were increased significantly after treatment （P〈0.05 or P〈0.01 ） while the level of LVMI of patients were decreased significantly （P〈0.05）. As compared with control group, the cardiac function and its size of Irbesartan group were improved significantly after 6 months of treatment （P〈0.05）. CONCLUSION： Irbesartan can improve cardiac function and its size significantly in RHD patients after valve surgery.