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目的研究血管紧张素转换酶抑制剂苯那普利和醛固酮受体拮抗剂安体舒通治疗慢性心衰室性心律失常的临床疗效。方法筛选慢性心衰室性心律失常住院患者98例,在基础抗心衰的同时应用苯那普利5～10mg/d和安体舒通20～40mg/d,服药前及服药后4wk分别测定血清钾、镁离子浓度及24h动态EKG,以及血管肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(Ald)、内皮素(ET)水平并对照比较,评估临床NYIIA分级。结果治疗4wk后心功能明显改善,血清钾、镁离子升高,室性早博明显减少,血浆PRA、AngⅡ、Ald,ET水平显著下降。结论苯那普利和安体舒通能抑制cm,使交感神经兴奋、肾素-血管紧张紊-醛固酮系统的活性降低,改善心功能,升高血清钾、镁离子,减少室性心律失常,降低恶性程度和降低心脏猝死率。
Objective To investigate the clinical effects of benazepril, an angiotensin converting enzyme inhibitor, and spironolactone, an aldosterone receptor antagonist, on ventricular arrhythmias in patients with chronic heart failure. Methods A total of 98 hospitalized patients with chronic heart failure and ventricular arrhythmias were enrolled in this study. Benazepril 5 ~ 10 mg / d and spironolactone 20 ~ 40 mg / d were administered simultaneously with basilar anti-heart failure, before and after 4 wk treatment Serum potassium and magnesium concentrations and dynamic EKG at 24 hours, as well as levels of PRA, Ald, Aldin and ET were compared to evaluate the clinical NYIIA classification. Results After 4 weeks of treatment, heart function improved significantly, serum potassium and magnesium increased, ventricular premature beats decreased significantly, plasma PRA, Ang Ⅱ, Ald, ET levels decreased significantly. Conclusion benazepril and spironolactone inhibit cm, so that sympathetic excitement, renin - angiotensin - aldosterone system activity decreased, improve cardiac function, increase serum potassium and magnesium ions, reduce ventricular arrhythmias, reduce Malignancy and reduce the rate of sudden cardiac death.