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目的 观察伊贝沙坦治疗重症充血性心力衰竭 (CHF)的临床疗效及其对血管紧张素Ⅱ (AngⅡ )和脑钠素(BNP)的影响。方法 76例重症充血性心力衰竭患者 ,随机分为伊贝沙坦组 ( 4 0例 )和对照组 ( 36例 ) ,对照组予以常规治疗 ,伊贝沙坦组在常规治疗基础上给予口服伊贝沙坦 75～30 0mg/d ,治疗 6月 ,观察治疗前后心胸比、左室舒张末期内径 (LVDd)和左室射血分数 (LVEF)的变化 ,评价心功能分级 ,并用放射免疫法测定血浆AngⅡ和BNP在治疗前后的改变。结果 治疗后伊贝沙坦组显效率明显高于对照组 ,心率、心胸比及LVDd均较治疗前明显下降 ,且明显低于对照组(P分别为 <0 0 5、<0 0 1) ,LVEF明显增加 (P <0 0 1)。血浆AngⅡ和BNP水平明显降低 ,并明显低于对照组 (P <0 0 1)。心功能改善 1～ 2级 ,药物副反应少 ,患者耐受性好。结论 伊贝沙坦治疗重症CHF疗效较好 ,并能在一定程度上改善心衰患者的神经内分泌机制失调
Objective To observe the clinical efficacy of irbesartan in the treatment of severe congestive heart failure (CHF) and its effect on angiotensin Ⅱ (Ang Ⅱ) and brain natriuretic peptide (BNP). Methods Sixty-six patients with severe congestive heart failure were randomly divided into 2 groups: irbesartan group (40 cases) and control group (36 cases). The control group was given conventional treatment. The irbesartan group was given oral Yi Beisartan 75 ~ 30 0mg / d, the treatment of 6 months, before and after treatment to observe the cardiothoracic ratio, left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) changes, evaluation of cardiac function classification and determination by radioimmunoassay Plasma Ang Ⅱ and BNP before and after treatment changes. Results After treatment, the apparent efficiency of irbesartan group was significantly higher than that of the control group. The heart rate, cardiothoracic ratio and LVDd were significantly lower than those before treatment (P <0.05, respectively) LVEF increased significantly (P <0.01). Plasma AngⅡ and BNP levels were significantly lower than those in the control group (P <0.01). Heart function improved 1 to 2, less side effects of drugs, patients with good tolerance. Conclusion Irbesartan in the treatment of severe CHF is effective and can improve the neuroendocrine mechanism in patients with heart failure to a certain extent