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目的:探讨氯沙坦和贝那普利联合治疗高血压性心脏病患者心功能康复的研究。方法:101例高血压伴心衰患者随机分为氯沙坦和贝那普利联合治疗组48例,贝那普利对照53例,对照组用贝那普利10 mg·d-1,氯沙坦组在对照组的用药基础上加氯沙坦50～100 mg·d-1。12月为一疗程,治疗前后用彩色超声心动图检测,反映心脏收缩功能及舒张功能等指标,治疗前后测定血浆中神经内分泌激素指标水平。结果:氯沙坦和贝那普利联合治疗组一年后,心脏收缩和舒张指标自身比较有统计学差异;对照组上述指标改变不明显(P>0.05)。治疗组治疗后,神经内分泌激素随着心功能改善上述指标逐渐下降,自身比较及与对照组比较有统计学差异(P<0.05)。临床疗效评定氯沙坦联合组总有效率95.83%,对照组总有效率66.03%,有统计学差异(P<0.05)。结论:氯沙坦联合组可抑制高血压病伴左室肥大患者神经内分泌激活,改善左室收缩及舒张功能,联合应用更显著,改善心功能作用优于贝那普利组。
Objective: To investigate the cardiac rehabilitation in patients with hypertensive heart disease treated with losartan and benazepril. Methods: A total of 101 patients with hypertension and heart failure were randomly divided into losartan and benazepril combined treatment group (n = 48) and benazepril control (n = 53). The control group was given benazepril 10 mg · d-1 Sedast group in the control group based on the medication plus losartan 50 ~ 100 mg · d-1.12 months for a program, before and after treatment with color echocardiography test to reflect cardiac systolic and diastolic function and other indicators before and after treatment Plasma levels of neuroendocrine hormones were measured. Results: After one year of losartan and benazepril combined treatment group, the indexes of cardiac systole and diastole were statistically different; the above indexes in the control group changed insignificantly (P> 0.05). After treatment, the neuroendocrine hormones decreased gradually with the improvement of cardiac function. Compared with the control group, there was a significant difference (P <0.05). The total clinical efficacy of Losartan combined group was 95.83%, 66.03% in the control group, with a statistically significant difference (P <0.05). CONCLUSION: Losartan combined can inhibit the neuroendocrine activation and improve left ventricular systolic and diastolic function in hypertensive patients with left ventricular hypertrophy. The combination of losartan and losartan is superior to benazepril in improving cardiac function.