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[目的]观察美托洛尔与依那普利治疗慢性心力衰竭(简称CHF)的疗效。[方法]采用临床实验,对CHF患者随机分为对照组和试验组,试验组在常规治疗基础上加用依那普利与美托洛尔,观察两组治疗前与治疗后15d、30d、45d、60d的静息心率(HR)、收缩压(SBP)、舒张压(DBP)、心功能等。[结果]试验组心功能改善2级33例(38.4%),改善1级47例(54.7%),无效6例(7.0%),总有效率93.0%,对照组心功能改善2级8例(9.4%),改善1级56例(65.9%),无效21例(24.7%),总有效率75.3%,两组心功能改善总有效率比较差异有统计学意义(P﹤0.001)。试验组平均住院18d,3个月复发9例,6个月复发12例,两组复发率差异有统计学意义(P﹤0.001)。[结论]CHF在常规治疗基础上加用美托洛尔与依那普利,可显著提高疗效,降低复发率,但依那普利宜小剂量开始递增,两药联用时剂量宜偏小,间开服药。
[Objective] To observe the efficacy of metoprolol and enalapril in the treatment of chronic heart failure (CHF). [Methods] The CHF patients were randomly divided into control group and experimental group with clinical trial. Enalapril and metoprolol were added to the experimental group on the basis of conventional treatment. The levels of pre-treatment and post-treatment 15d, 30d, Resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart function and so on 45d, 60d. [Results] The improvement of heart function in the experimental group was 33 cases (38.4%) in grade 2, 47 cases (54.7%) were improved in grade 1, 6 cases were ineffective (7.0%), the total effective rate was 93.0% (9.4%). There were 56 cases (65.9%) in grade 1 improvement, 21 cases (24.7%) were ineffective, and the total effective rate was 75.3%. There was significant difference between the two groups in the total effective rate of cardiac function improvement (P <0.001). In the experimental group, the average hospitalization was 18 days, 9 cases were recurrence in 3 months and 12 cases were recurrence in 6 months. There was significant difference between the two groups (P <0.001). [Conclusion] The combination of metoprolol and enalapril on the basis of conventional treatment can significantly improve the curative effect and reduce the recurrence rate. However, enalapril should be given as a small dose and the dosage should be smaller. Open medication.