替米沙坦对扩张型心肌病心室重塑和心功能的影响

目的:观察国产替米沙坦对扩张型心肌病患者的心室重塑和心功能的影响。方法:扩张型心肌病并心力衰竭患者62例,随机分为替米沙坦治疗组和西拉普利对照组。在常规强心、利尿等抗心力衰竭治疗的基础上,替米沙坦治疗组给予口服替米沙坦40m g/d,西拉普利对照组给予口服西拉普利2.5m g/d,治疗前及治疗后6个月超声心动图观察心脏结构及左心室收缩功能的变化及对心功能的影响。结果:在治疗6个月期间,与治疗前相比两组患者心功能得到明显改善。治疗组总有效率为84.38%,对照组为86.67%(P>0.05)。治疗组心功能改善与对照组无显著性差异。使用替米沙坦后6个月左室射血分数,短轴缩短率明显改善,舒张期左室后壁厚度(LVPW T)、舒张期室间隔厚度(IV ST)、左心房内径(LA)、左室收缩末内径(LVESd)、左室舒张末内径(LVEDd)、心胸比例明显下降(P<0.05)。结论:国产替米沙坦能显著改善扩张型心肌病患者的左室收缩功能,并逆转心室重构,与血管紧张素转换酶抑制剂同样安全有效。

Effect of telmisartan on reverse remodeling and improvement of cardiac function in dilated cardiaomyopathy patients

Objective:To observe effects of telmisartan on reverse remodeling and improvement of cardiac function in dilated cardiaomyopathy patients.Methods: 62 patients with dilated cardiaomyopathy and heart failure were randomly divided into two groups,both of them were treated for basic heart failure,with digilalis,diuretics,vasodilators etc.Group A were given temisartan 40mg orally once a day for 3 months,group B were given angiotensin converting enzyme inhibitor cilazapril 2.5 mg orally once a day for 3 months.Results: The symptoms significantly improved in both groups compared with those before therapy(P<0.05).There was no significant difference in the total effective rate between two groups(87% vs 89%,P>0.05).After 3 months treatment,BP and LVEDd decreased significantly(P<0.05),cardiac function,LVEF,CO and FS increased significantly(P<0.05),and few adverse effects were observed and patients tolerance was perfect.Conclusion: The efficacy of Telmisartan in treatment of dilated cardiaomyopathy with heart failure is satisfactory.Telmisartan is as effective as ACEI in treatment of dilated cardiaomyopathy with heart failure.