厄贝沙坦氢氯噻嗪辅助治疗老年重症心力衰竭的效果及对血流动力学的影响

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摘要目的研究厄贝沙坦联合氢氯噻嗪辅助美托洛尔治疗老年重症心力衰竭的效果及其对血流动力学的影响。方法选取2015年12月～2017年1月在我院治疗并确诊重症心力衰竭的97例老年患者作为研究对象，根据随机对照法将其分为研究组（n=47）和对照组（n=50）。对照组患者给予口服酒石酸美托洛尔片治疗，研究组患者在此基础上再给予厄贝沙坦、氢氯噻嗪片治疗，共治疗2个月。比较两组患者的治疗效果、治疗前后心脏结构及血流动力学指标变化、不良反应发生情况。结果研究组患者的治疗总有效率明显高于对照组，差异有统计学意义（P＜0.05）。治疗后，研究组患者的左心室射血分数（LVEF）明显高于对照组，两组患者的LVEF均明显高于治疗前，差异有统计学意义（P＜0.05）。治疗后，两组患者的体循环血管阻力（SVR）、肺动脉楔压（PAWP）、肺动脉平均压（PAMP）、右心房压（RAP）均低于治疗前，心排血量（CO）、心脏指数（CI）较高于治疗前，差异有统计学意义（P＜0.05）。治疗后，研究组患者的PAWP、PAMP、SVR明显低于对照组，CO高于对照组，差异有统计学意义（P＜0.05），而两组患者的RAP、CI比较，差异无统计学意义（P＞0.05）。两组患者治疗期间的药物不良反应总发生率比较，差异无统计学意义（P＞0.05）。结论厄贝沙坦联合氢氯噻嗪辅助治疗老年重症心力衰竭患者的效果优于单纯使用美托洛尔，且对患者的血流动力学改善作用较为明显。

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	王睿
	黄华杰
	林进爵

关键词 ：厄贝沙坦, 氢氯噻嗪, 心力衰竭, 血流动力学, 辅助治疗

Abstract：ObjectiveTo study the effect of Irbesartan combined with Hydrochlorothiazide and Metoprololin in the treatment of elderly patients with severe heart failure and its hemodynamic impacts.MethodsAltogether 97 cases of elderly patients who were confirmedly diagnosed with severe mental failure and treated in our hospital from December 2015 to January 2017 were selected as subjects and were divided into the study group(n=47)and the control group(n=50)according to the random control method.The control group was given oral Metoprolol Tartrate Tablets,and the study group was given Irbesartan and Hydrochlorothiazide Tablets on the basis of control group.The therapeutic effects of the two groups of patients were compared,the changes of cardiac structure and hemodynamic indexes before and after treatment,and the occurrence of adverse reactions were also compared between the two groups.ResultsThe total effective rate of the study group was significantly higher than that of the control group,the difference was statistically significant(P＜0.05).The left ventricular ejection fraction(LVEF)of the study group was significantly higher than that of the control group,and the LVEF after treatment of the two groups was significantly higher than that before the treatment,the differences were statistically significant(P＜0.05).After treatment,the systemic vascular resistance(SVR),pulmonary artery wedge pressure(PAWP),pulmonary artery mean pressure(PAMP)and right atrial pressure(RAP)of two groups were significantly lower than those before treatment,the post-treatment cardiac output(CO)and cardiac index　(CI)were significantly higher than those before treatment,the differences were statistically significant(P＜0.05).After treatment,the PAWP,PAMP and SVR of the study group were significantly lower than those of the control group,the CO was higher than that in the control group,the differences were statistically significant　(P＜0.05),but there was no statistically significant difference between the two groups in RAP and CI(P＞0.05).The total incidence of adverse drug reactions between the two groups was compared,and the difference was not statistically significant(P＞0.05).ConclusionThe application of combination of Irbesartanand and Hydrochlorothiazide demonstrates its better effectiveness in the adjuvant treatment of elderly patients with severe mental failure and improve patients′hemodynamics more obviously in contrast with single application of Metoprolol.

Key words： Irbesartan Hydrochlorothiazide Heart failure Hemodynamics Adjuvant therapy

作者简介: 王睿（1984-），男，汉族，广东廉江人，本科，主治医师，研究方向：心血管内科危重病的救治

引用本文:

王睿;黄华杰;林进爵. 厄贝沙坦氢氯噻嗪辅助治疗老年重症心力衰竭的效果及对血流动力学的影响[J]. 中国当代医药, 2018, 25(18): 87-90.
WANG Rui;HUANG Hua-jie;LIN Jin-jue. Effect of Irbesartan and Hydrochlorothiazidein adjuvant treatment of elderly patients with severe heart failure and its hemodynamic impacts. 中国当代医药, 2018, 25(18): 87-90.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2018/V25/I18/87

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