CAJ | 학술논문

目的观察血管紧张素受体拮抗剂(ARB)、β受体阻滞剂单用及联合应用对扩张型心肌病(DCM)的临床疗效.方法将95例DCM患者随机分为ARB组(A组)32例,给予厄贝沙坦150 mg,1次/d,无不良反应,渐增量300 mg；β受体阻滞剂组(B组)30例,给予比索洛尔1.25 mg,1次/d,无不良反应,每1～2周剂量倍增至患者能耐受；ARB和β受体阻滞剂联合组(AB组)33例,以上两药联合应用至患者能耐受的最大剂量.三组均长期维持治疗,疗程12个月.结果 A、B、AB三组总有效率分别为84.37％、80.40％、93.93％,AB组与A、B组差异均有统计学意义(x2=4.95、3.95,均P＜0.05),三组治疗后6 min步行距离、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左室射血分数(LVEF)与治疗前比较,差异均有统计学意义(均P＜0.05),A组与B组差异无统计学意义(P＞0.05),AB组与A组及B组差异均有统计学意义(均P＜0.05).结论 ARB与β受体阻滞剂联合治疗DCM疗效优于单用ARB或β受体阻滞剂,且耐受好.
목적 관찰혈관긴장소수체길항제(ARB)、β수체조체제단용급연합응용대확장형심기병(DCM)적림상료효.방법 장95례DCM환자수궤분위ARB조(A조)32례,급여액패사탄150 mg,1차/d,무불량반응,점증량300 mg；β수체조체제조(B조)30례,급여비색락이1.25 mg,1차/d,무불량반응,매1～2주제량배증지환자능내수；ARB화β수체조체제연합조(AB조)33례,이상량약연합응용지환자능내수적최대제량.삼조균장기유지치료,료정12개월.결과 A、B、AB삼조총유효솔분별위84.37％、80.40％、93.93％,AB조여A、B조차이균유통계학의의(x2=4.95、3.95,균P＜0.05),삼조치료후6 min보행거리、좌실서장말기내경(LVEDd)、좌실수축말기내경(LVESd)、좌실사혈분수(LVEF)여치료전비교,차이균유통계학의의(균P＜0.05),A조여B조차이무통계학의의(P＞0.05),AB조여A조급B조차이균유통계학의의(균P＜0.05).결론 ARB여β수체조체제연합치료DCM료효우우단용ARB혹β수체조체제,차내수호.
Objective To investigate the effects of ARB or/and β-blocker in treatment of dilated cardiomyopathy(DCM).Methods 95 cases with DCM were randomly divided into 3 groups.ARB group(A,32 cases) was treated with Irbesartan,150 mg/d without adverse drug reaction and then to 300 mg/d weekly; β-blocker group( B,30cases) was treated with Bisoprolol,1.25 mg/d without adverse drug reaction and then to maximal dose weekly; combination group( AB,33 cases) was treated with Irbesartan and Bisoprolol to maximal dose which patients were able to tolerate.The 3 groups were observed for a period of 12 months.Results Comparing with pretreatment,the results of 6min walk,LVEDd,LVESd,LVEF were improved significantly( all P ＜0.05).There were no significant differences between A group and B group(P ＞0.05),but the differences between combination group and A group or B group were significant( P ＜0.05 ).Conclusion Effect of ARB combined with β-blocker was better than that of ARB or β-blocker alone in treatment of DCM and well tolerated.