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目的 观察血管紧张素Ⅱ受体拮抗剂 (ARB)缬沙坦与血管紧张素转换酶抑制剂 (ACEI)依那普利对慢性心力衰竭 (CHF)患者远期预后的影响。方法 选择CHF患者 2 6 1例 ,随机分为缬沙坦治疗组 (137例 )和依那普利治疗组 (12 4例 ) ,其他治疗方案一致。在治疗前和观察期满 2年时分别对心功能NYHAⅡ～Ⅲ级患者做踏车负荷试验 ,记录患者所能耐受的最大运动功率和运动持续时间。结果 2年期间 ,缬沙坦治疗组和依那普利治疗组因心力衰竭加重再住院率分别为 2 5 6 2 %和 2 8 35 % (P >0 0 5 ) ,病死率分别为 8 0 3%和 10 4 8% (P >0 0 5 ) ;两组患者心功能 (NYHA分级 )、最大运动功率和运动持续时间间差别均无显著性意义 (P >0 0 5 )。结论 缬沙坦和依那普利均可显著改善CHF患者的远期预后。
Objective To investigate the long-term prognosis of patients with chronic heart failure (CHF) by valsartan and angiotensin converting enzyme inhibitor (ACE inhibitor) of angiotensin Ⅱ receptor antagonist (ARB). Methods Twenty-six patients with CHF were randomly divided into valsartan treatment group (137 cases) and enalapril treatment group (124 cases), and the other treatment regimens were the same. Before treatment and 2 years after the observation period, treadmill load test was performed on NYHA class Ⅱ ~ Ⅲ patients with cardiac function. The maximal exercise power and exercise duration were recorded. Results During 2 years, the rate of rehospitalization due to heart failure in valsartan-treated and enalapril-treated groups was 2562% and 285%, respectively (P 0 05), and mortality rates were 80 3% and 104.8% respectively (P> 0.05). There was no significant difference between the two groups in NYHA classification, maximum exercise power and exercise duration (P> 0.05). Conclusion Both valsartan and enalapril can significantly improve the long-term prognosis of CHF patients.