缬沙坦联合卡维地洛对射血分数正常心力衰竭患者心功能及心肌重构的影响

摘要

目的:研究缬沙坦联合卡维地洛对射血分数正常心力衰竭(HFPEF)患者心功能和心肌重构的影响. 方法:选择我院收治的老年HFPEF患者92例为研究对象, 随机分为常规治疗组和联合治疗组(在常规治疗基础上接受缬沙坦联合卡维地洛治疗), 每组46例, 治疗6个月后比较两组患者的临床疗效、心功能、心肌重构指标变化以及不良反应. 结果:治疗后联合治疗组总有效率明显高于常规治疗组(93. 48％比78. 26％, P=0. 036). 与常规治疗组比较, 联合治疗组治疗后血压[(120. 26±9. 17)/(73. 56±5. 86)mmHg比(115. 68±10. 31)/(67. 24±4. 92)mmHg]、心率[(74. 35±8. 53)次/min比(68. 48±7. 17)次/min]和BNP[(299. 86±19. 43)pg/ml比(231. 71±20. 15)pg/ml]水平均显著下降, E/A[(1. 02±0. 09)比(1. 26±0. 07)]、LVEF[(53. 14±1. 60)％比(57. 02±1. 51)％]均显著升高, IVRT[(119. 45±14. 23)ms比(102. 17±11. 53)ms]和LAVI[(35. 82±7. 15)ml/m2比(30. 17±6. 48)ml/m2]显著减少, LVEDd[(57. 22±7. 24)mm比(50. 61±6. 35)mm]、LVESd[(50. 14±5. 06)mm比(44. 93±5. 82)mm]均显著减小(P＜0. 05或＜0. 01). 治疗期间, 两组患者均未发生明显不良反应. 结论:缬沙坦联合卡维地洛对射血分数正常心力衰竭患者, 可以显著提高疗效, 改善心功能和心肌结构, 值得临床推广.%Objective: To study therapeutic effect of valsartan combined carvedilol on patients with heart failure with preserved ejection fraction (HFPEF) and its influence on heart function and myocardial remodeling. Methods: A total of 92 aged HFPEF patients treated in our hospital were selected. They were randomly and equally divided into routine treatment group and combined treatment group (received valsartan combined carvedilol based on routine treatment), and both groups were treated for six months. Therapeutic effect, heart function, myocardial remodeling indexes and adverse reactions were compared between two groups after six months. Results: Total effective rate of combined treatment group was significantly higher than that of routine treatment group (93. 48％ vs. 78. 26％, P=0. 036). Compared with routine treatment group after treatment, there were significant reductions in blood pressure [(120. 26±9. 17) / (73. 56±5. 86) mmHg vs. (115. 68±10. 31) / (67. 24±4. 92) mmHg], heart rate [(74. 35±8. 53) beats/min vs. (68. 48±7. 17) beats/min]and BNP level [(299. 86±19. 43) pg/ml vs. (231. 71± 20. 15) pg/ml], significant rise in E/A [(1. 02±0. 09) vs. (1. 26±0. 07)] and LVEF [(53. 14±1. 60) ％ vs. (57. 02±1. 51) ％]; and significant reductions in IVRT [(119. 45±14. 23) ms vs. (102. 17±11. 53) ms], LAVI [(35. 82±7. 15) ml/m2 vs. (30. 17±6. 48) ml/m2], LVEDd [(57. 22±7. 24) mm vs. (50. 61±6. 35) mm]and LVESd [(50. 14±5. 06) mm vs. (44. 93±5. 82) mm]in combined treatment group, P＜0. 05 or＜0. 01. During treatment, no obvious adverse reactions occurred in two groups. Conclusion: Valsartan combined carvedilol can significantly increase effective rate, improve heart function and myocardial construction in HFPEF patients. Which is worth extending.