坎地沙坦與貝那普利治療慢性充血性心力衰竭的效果及對神經內分泌激素活性的影響

韓美如

【摘要】 目的：比較慢性充血性心力衰竭（CCHF）治療中坎地沙坦及貝那普利的應用價值及對神經內分泌激素活性的影響。方法：選取2018年1月-2019年3月本院收治的CCHF患者80例為研究對象，應用隨機數字表法將其分為坎地沙坦組（接受坎地沙坦治療）和聯合組（接受坎地沙坦及貝那普利治療），每組40例。比較兩組治療過程中LVEDD、LVEF及神經內分泌激素活性變化情況及不良反應發生情況。結果：治療12、24周時，聯合組的LVEDD均低于坎地沙坦組，LVEF均高于坎地沙坦組，差異均有統計學意義（P<0.05）;治療過程中，兩組的LVEDD均呈降低趨勢，治療24周均低于治療12周及入組時，差異均有統計學意義（P<0.05）;兩組的LVEF呈升高趨勢，治療24周均高于治療12周及入組時，差異均有統計學意義（P<0.05）。治療12、24周時，聯合組的AngⅡ、ALD及BNP均低于坎地沙坦組，差異均有統計學意義（P<0.05）;治療過程中，兩組的AngⅡ呈升高趨勢，治療24周均高于治療12周及入組時，差異均有統計學意義（P<0.05）;兩組的ALD及BNP均呈降低趨勢，治療24周均低于治療12周及入組時，差異均有統計學意義（P<0.05）。兩組并發癥發生率比較，差異無統計學意義（P>0.05）。結論：坎地沙坦聯合貝那普利可有效地提高CCHF的治療效果，同時可有效地改善患者的神經內分泌激素活性。

【關鍵詞】 坎地沙坦 貝那普利 慢性充血性心力衰竭 神經內分泌激素

[Abstract] Objective： To compare the value of Candesartan and Benazepril in the treatment of chronic congestive heart failure （CCHF） and the effect on neuroendocrine hormone activity. Method： A total of 80 CCHF patients admitted to our hospital from January 2018 to March 2019 were selected as the study objects. Using the random number table method， they were divided into the Candesartan group （treatment with Candesartan） and the combined group （treatment with Candesartan and Benazepril）， 40 cases in each group. The changes and adverse reactions of LVEDD， LVEF and neuroendocrine hormones in the two groups were compared. Result： At treatment 12 and 24 weeks， the LVEDD of the combined group were lower than those of the Candesartan group， LVEF were higher than those of Candesartan group， the differences were statistically significant （P<0.05）. During the treatment， the LVEDD of both groups showed a decreasing trend， the 24 weeks of treatment were all lower than those of the 12 weeks of treatment and the group was enrolled， the differences were statistically significant （P<0.05）. The LVEF of the two groups showed an increasing trend， 24 weeks of treatment were higher than those of 12 weeks of treatment and the group was enrolled， the differences were statistically significant （P<0.05）. At treatment 12 and 24 weeks， AngⅡ， ALD and BNP of the combined group were lower than those of the Candesartan group， the differences were statistically significant （P<0.05）. During the treatment， AngⅡ of two groups showed a trend of increase， 24 weeks of treatment were higher than those of 12 weeks of treatment and the group was enrolled， the differences were statistically significant （P<0.05）. ALD and BNP in both groups showed a decreasing trend， the 24 weeks of treatment were all lower than those of the 12 weeks of treatment and the group was enrolled， the differences were statistically significant （P<0.05）. The complication rate of the two groups was compared， the difference was not statistically significant （P>0.05）. Conclusion： Candesartan combined with Benazepril can effectively improve the therapeutic effect of CCHF and the neuroendocrine hormone activity of patients.Key words] Candesartan Benazepril Chronic congestive heart failure Neuroendocrine hormoneFirst-authors address： Qingxi Hospital of Dongguan City， Dongguan 523660， China

慢性充血性心力衰竭（CCHF）屬心血管疾病終末期所出現的臨床綜合征，可導致患者的心排血量顯著降低，不僅可對患者的生活質量造成嚴重影響，同時也對患者的生命安全造成了嚴重的威脅[1-2]。雖然目前臨床已經形成了較為完備的治療方案，但治療方案中不同的藥物搭配，其所達到的治療效果同樣也存在一定的差異[3-5]。本研究對比分析坎地沙坦及貝那普利在CCHF治療中的應用價值及對神經內分泌激素活性的影響，以期更為有效的指導臨床治療，現報道如下。

1 資料與方法

1.1 一般資料 選取2018年1月-2019年3月本院收治的CCHF患者80例為研究對象，（1）納入標準：①符合《中國心力衰竭診斷和治療指南2014》中CCHF的診斷標準[6];②年齡18～75歲。（2）排除標準：①近1個月內發生急性心肌梗死者;②存在惡性心律失常、心源性休克者;③存在低血壓者;④對本研究應用的治療藥物過敏或無法耐受者;⑤存在肝腎功能不全者;⑥合并惡性腫瘤者;⑦合并腦血管疾病、意識障礙者。……