血管紧张素转换酶抑制剂治疗慢性充血性心力衰竭有效剂量探讨

目的探讨不同剂量血管紧张素转换酶抑制剂（ACEI）卡托普利治疗慢性充血性心力衰竭（CHF）疗效。方法CHF患者56例，随机分为卡托普利高剂量组n=28，150mg／d，低剂量组n=28，25mg／d，疗程24周。观察治疗前后两组临床症状、超声心动图心功能指标并记录不良反应发生情况。结果高剂量组总有效率89．3％，明显优于低剂量组60．7％（P〈0．01），左心室功能指标每搏量（SV）、心排出量（CO）、射血分数（EF）、左室短轴缩短率（FS）治疗后与治疗前比较，高剂量组有显著改善（P〈0．01），低剂量组变化不大（P〉0．05）。结论大剂量（目标剂量）ACEI较小剂量更有效改善心功能。

The effective dosage of angiotensin converting enzyme inhibitor(ACEI)in the treatment of congestive heart failure

Objective To study effective dosage of ACEI Captopril in the treatment of congestive heart failure. Methods 56 patients with CHF were allocated randomly into two groups,28 cases with high doses of Captopril（ 150 mg/d）and 28 cases with low doses of Captopril （25 mg/d）, they were treated for 24 weeks. The clinical therapeutic efficacy, LVEF.SV,CO,FS and adverse reaction were analyzed. Results The total rate of the high dose group was 89. 3%, which was significantly higher than that of the low dose group60. 7% （P 〈 0. 01 ）, After 20 weeks treatment, LVEF.SV.CO,FS were significantly improved in the high dose group as compared with those of the low dose group. Conclusion The high dose （ Target dose） of ACEI is better than the low dose of ACEI in the treatment of CHF.