培哚普利对充血性心力衰竭患者左心室重构及血流动力学的影响

摘要

目的 观察培哚普利对充血性心力衰竭(CHF)患者左心室重构及血流动力学的影响.方法 2009年7月至2011年7月在我院确诊为CHF的103例患者纳入研究.所有患者在服用地高辛、利尿剂、β受体阻滞剂基础上坚持服用培哚普利6个月.治疗前后测量左室重量(LVMW)、室间隔厚度(IVS)、左室后壁厚度(LVPW)、左室舒张末期内径(LVID)、E/A比值、左室射血分数(LVEF).取连续3个心动周期的平均值.同时,测量患者6 min步行距离、心功能分级、舒张压(SBP)、收缩压(DBP)及心率(HR).观察治疗后不良反应的发生情况.结果 治疗后发生轻度咳嗽2例,皮疹1例,但均可耐受,不影响继续治疗.治疗后6个月与治疗前比较,LVMW、WS、LVID均明显降低,LVEF、E/A比值明显升高.两组比较,除IVS、LVPW差异无统计学意义外(P＞0.05),LVID、LVMW、LVEF及E/A比值差异均有统计学意义(P＜0.05).患者心功能分级、6min步行距离、SBP、DBP及HR均明显改善,差异有统计学意义(P＜0.05).结论 培哚普利能明显改善CHF患者左心室重构及血流动力学指标.%Objective To observe the effect of perindopril on left ventricular remodeling and hemodynamics in congestive heart failure (CHF) patients. Methods One hundred and three patients with CHF from July 2009 to July 2011 were enrolled in this study. All the patients were given perindopril orally once a day on the basis of taking di-goxin, diuretic and β-blockers totally for 6 months. Before and after the treatment, the LVMW, IVS, LVPW, LVID, LVESD, E/A value, LVEF, 6 minutes walking distance, NYHA, SBP, DBP and HR were detected. In addition, the adverse reactions after the treatment were also observed. Results There were 2 patients with mild cough and 1 patient with rash after the treatment. Compared with before treatment, LVMW, IVS and LVID 6 months after treatment were significantly decreased, and LVEF and E/A value were significantly increased. The differences of IVS and LVPW were not statistically significant, while the differences of LVID, LVMW, LVEF and E/A value were statistically significant (P<0.05). There were big improvements in 6 minutes walking distance, NYHA, SBP, DBP and HR after the treatment (P<0.05). Conclusion Perindopril can significantly improve the situation of left ventricular remodeling and hemodynamics in CHF patients.