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目的:试论培哚普利与坎地沙坦倍增剂量在老年退行性心脏瓣膜病心力衰竭患者治疗中的效果。方法:将123例老年退行性心脏瓣膜病心力衰竭患者随机分为常规组、培哚普利组和坎地沙坦组,三组各为41人,常规组采取单纯的抗心力衰竭治疗,培哚普利组采取培哚普利治疗,治疗的前两周每天4mg,之后调整为每天8mg;坎地沙坦组采取地沙坦治疗,治疗的前两周每天4mg,之后调整为每天8mg,对比三组的临床治疗效果。结果:培哚普利组的左室质量指数、血清脑钠肽、血清高敏C反应蛋白明显下降;坎地沙坦组左室质量指数、血清脑钠肽有所下降,血清高敏C反应蛋白明显下降;常规组的治疗总有效率为68.29%;培哚普利组的治疗总有效率为92.68%,坎地沙坦组治疗总有效率为85.37%,差异具有统计学意义(P<0.05)。结论:培哚普利与坎地沙坦在老年退行性心脏瓣膜病心力衰竭患者治疗,其临床效果显著,减轻了患者的左室肥厚,在临床上值得推广使用。
OBJECTIVE: To evaluate the efficacy of doubled doses of perindopril and candesartan in the treatment of patients with heart failure in elderly patients with degenerative heart valvular disease. Methods: A total of 123 elderly patients with heart disease with valvular heart disease were randomly divided into routine group, perindopril group and candesartan group, with 41 patients in each group. The patients in conventional group were treated with anti-heart failure alone. Perindopril groups were treated with perindopril, 4mg daily for the first two weeks of treatment, then 8mg per day; candesartan was given to candesartan 4mg daily for the first two weeks of treatment, then adjusted to 8mg daily, Comparison of three groups of clinical treatment. Results: The left ventricular mass index, serum brain natriuretic peptide and serum high sensitive C-reactive protein were significantly decreased in perindopril group. Left ventricular mass index and serum brain natriuretic peptide were decreased in candesartan group and serum high-sensitivity C-reactive protein (P <0.05). The total effective rate was 68.29% in the conventional group, 92.68% in the perindopril group and 85.37% in the candesartan group, the difference was statistically significant (P <0.05) . CONCLUSION: Perindopril and candesartan are effective in the treatment of patients with senile degenerative heart valvular heart failure. The clinical effect of perindopril and candesartan is significant and the left ventricular hypertrophy of patients is alleviated. It is worth to be popularized in clinic.