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我院近年来应用巯甲脯酸治疗慢性肺心病心衰患者30例,取得较好疗效,现报告如下。 1 临床资料 病例选择:本组慢性肺心病诊断均符合1980年全国第三次肺心病专业会议修订标准。本组30例病因均为COPD,其中男17例,女13例,年龄30—80岁,平均57岁。有慢支病史10—28年肺心病史1—20年。心功能按NYHA分类,Ⅳ级16例,置级12例,Ⅱ级2例。 2 治疗方法 本组病人均常规抗感染、持续低流量吸氧、纠正酸碱紊乱及常规强心利尿等综合治疗。心衰未能控制而加用巯甲丙脯酸治疗。剂量12.5—25mg,每日2—3次口服,根据血压、心衰控制情况调整剂量。疗程7—14天。治疗过程中观察紫绀、颈静脉怒张肺部罗音、肝大、水肿、心率、血氧指标等变化为判断疗效的根据。 3 疗效判断标准
In our hospital in recent years the application of captopril treatment of chronic heart failure in patients with pulmonary heart disease in 30 cases, and achieved good results, are as follows. 1 Clinical data Case selection: The diagnosis of chronic pulmonary heart disease in this group are in line with the third national conference of pulmonary heart disease in 1980 revised standards. The causes of this group of 30 patients were COPD, including 17 males and 13 females, aged 30-80 years, mean 57 years. A history of chronic bronchitis 10-28 years history of pulmonary heart disease 1 - 20 years. According to the NYHA classification, 16 cases were grade Ⅳ, 12 cases were classified as grade 2 and 2 cases were grade Ⅱ. 2 treatment The patients were routine anti-infection, sustained low flow oxygen, correct acid-base disorders and conventional cardiac diuretic and other comprehensive treatment. Heart failure failed to control the addition of captopril treatment. Dose 12.5-25mg, 2-3 times a day orally, according to blood pressure, heart failure to adjust the dose control. 7-14 days course of treatment. Cyanosis observed during treatment, jugular vein rales pulmonary rales, hepatomegaly, edema, heart rate, blood oxygen and other indicators to determine the basis for change. 3 efficacy criteria