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目的:观察厄贝沙坦治疗充血性心力衰竭的效果。方法:112例充血性心力衰竭患者随机分为对照组与观察组各56例。对照组均口服血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitors,ACEI)+螺内酯片,心功能Ⅳ级者联合硝酸甘油注射液5 mg+质量分数5%葡萄糖注射液250 mL,1次/d,静脉滴注;心功能Ⅳ级以下者联合口服酒石酸美托洛尔片。观察组均停用ACEI类药物,螺内酯片、硝酸甘油、酒石酸美托洛尔片用法、用量同对照组,并口服厄贝沙坦75 mg/次,1次/d,于第7天增至150 mg/次,1次/d。2组疗程均为24周。比较2组治疗前、后左心室射血分数、左心室舒张末期容积、左心室收缩末期容积、心胸比;并行6 min步行试验,观察2组步行距离,步行前后心率、血压、心肌耗氧量。结果:2组治疗后左心室射血分数较治疗前增加,左心室舒张末期容积、左心室收缩末期容积、心胸比较治疗前降低(P<0.05);2组治疗后上述各项指标比较差异有统计学意义(P<0.05)。治疗后观察组6min步行距离较对照组延长(P<0.05),心肌耗氧量较对照组降低(P<0.05)。结论:厄贝沙坦治疗充血性心力衰竭的疗效优于ACEI类药物。
Objective: To observe the effect of irbesartan on congestive heart failure. Methods: One hundred and twelve patients with congestive heart failure were randomly divided into control group and observation group with 56 cases each. The control group were given oral angiotensin converting enzyme inhibitors (ACEI) + spironolactone tablets, heart function grade Ⅳ combined with nitroglycerin injection 5 mg + 5% glucose injection 250 mL, 1 / d, Intravenous infusion; cardiac function below grade Ⅳ combined oral metartreol tartrate tablets. The observation group were discontinued ACEI drugs, spironolactone tablets, nitroglycerin, metoprolol tartrate tablets usage, the same amount as the control group, and oral irbesartan 75 mg / time, 1 / d, increased to 7 days 150 mg / time, 1 time / d. The two courses of treatment were 24 weeks. The left ventricular ejection fraction, left ventricular end-diastolic volume, left ventricular end-systolic volume and cardiothoracic ratio were compared between the two groups before and after treatment. The 6-minute walking test was performed to observe the walking distance, heart rate, blood pressure, myocardial oxygen consumption . Results: Left ventricular ejection fraction (LVEF) increased, left ventricular end-diastolic volume, left ventricular end-systolic volume, and cardiothoracic decreased after treatment in both groups (P <0.05). There was significant difference between the two groups Statistical significance (P <0.05). After treatment, the observation group 6min walk distance longer than the control group (P <0.05), myocardial oxygen consumption than the control group decreased (P <0.05). Conclusion: Irbesartan is superior to ACEI in the treatment of congestive heart failure.