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目的分析不同剂量贝那普利治疗慢性充血性心力衰竭(CCHF)的临床疗效,以及对患者生活质量和相关生化指标的影响,以期为贝那普利在临床的合理应用提供更加丰富的参考资料。方法选择2014年6月至2016年6月新疆生产建设兵团第九师医院收治的88例CCHF患者为研究对象,将88例患者根据随机数字表法分为20 mg剂量组和10mg剂量组,每组44例。10 mg剂量组在常规治疗基础之上加用贝那普利10 mg/d,20 mg剂量组加用贝那普利20 mg/d,两组均连续治疗6个月。比较两组的临床疗效及治疗前后心功能、生活质量、相关生化指标水平及血压的变化。用SPSS 17.0统计软件进行数据的统计处理,计量资料的组间比较用t检验,计数资料的组间比较用χ~2检验。结果 20 mg剂量组的总有效率(93.18%)高于10 mg剂量组(81.82%),但差异无统计学意义(P>0.05)。治疗后,两组患者左室射血分数(LVEF)均较治疗前明显升高,左室舒张末期内径(LVEDD)、明尼苏达心力衰竭生活质量量表(MLHFQ)评分、血清中同型半胱氨酸(Hcy)、血浆中胱抑素C(Cys-C)水平均较治疗前明显降低,差异均有统计学意义(P<0.05),且20 mg剂量组患者治疗后LVEF明显高于10 mg剂量组,LVEDD、MLHFQ评分、Hcy和Cys-C水平均明显低于10 mg剂量组治疗后,差异均有统计学意义(P<0.05)。治疗后,两组患者收缩压和舒张压均较本组治疗前明显降低,且20 mg剂量组明显低于10 mg剂量组,差异均有统计学意义(P<0.05)。20 mg剂量组不良反应发生率高于10 mg剂量组,差异有统计学意义(χ~2=6.640,P<0.05)。结论 20 mg/d贝那普利治疗CCHF的临床疗效更显著,可有效改善患者的心功能,提高生活质量,降低血液中Hcy、Cys-C水平,还具有降压作用。
Objective To analyze the clinical efficacy of benazepril in the treatment of chronic congestive heart failure (CCHF) with different doses, as well as the impact on the quality of life and related biochemical parameters in patients with benign prostatic hyperplasia, in order to provide a more abundant reference for the rational clinical application of benazepril . Methods Eighty-eight CCHF patients admitted to the Ninth Division of Xinjiang Production and Construction Corps between June 2014 and June 2016 were selected as the study subjects, and 88 patients were divided into 20 mg dose group and 10 mg dose group according to random number table Group of 44 cases. 10 mg dose group plus benazepril 10 mg / d, 20 mg dose group plus benazepril 20 mg / d on the basis of routine treatment, both groups were treated for 6 months. The clinical efficacy and the changes of cardiac function, quality of life, related biochemical indexes and blood pressure before and after treatment were compared between the two groups. SPSS 17.0 statistical software for statistical data processing, measurement data between the groups using t test, count data between the groups were compared using χ ~ 2 test. Results The total effective rate (93.18%) in the 20 mg dose group was higher than that in the 10 mg dose group (81.82%), but the difference was not statistically significant (P> 0.05). After treatment, left ventricular ejection fraction (LVEF) was significantly higher in both groups than before treatment, LVEDD, MLHFQ, serum homocysteine (P <0.05). The LVEF of patients in 20 mg dose group was significantly higher than that of 10 mg dose (P <0.05). The levels of Hcy and Cys-C in plasma were significantly lower than those before treatment The levels of LVEDD, MLHFQ, Hcy and Cys-C were significantly lower than those of 10 mg group after treatment (P <0.05). After treatment, systolic and diastolic blood pressure were significantly lower in both groups than before treatment, and the difference was statistically significant (P <0.05) in the 20 mg group and 10 mg group. The incidence of adverse reactions in the 20 mg dose group was higher than that in the 10 mg dose group (χ ~ 2 = 6.640, P <0.05). Conclusion The clinical efficacy of 20 mg / d benazepril in the treatment of CCHF is more significant, which can effectively improve the patients’ cardiac function, improve the quality of life, reduce the levels of Hcy and Cys-C in the blood and also have antihypertensive effects.