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目的研究比索洛尔、依那普利及螺内酯三联疗法对风湿性心脏病合并慢性心衰患者的疗效及安全性。方法选择2010年2月-2015年2月我院收治的62例风湿性心脏病合并慢性心衰患者。以数字法随机分成观察组(31例)和对照组(31例)。对照组进行常规治疗,观察组采用比索洛尔、依那普利及螺内酯三联疗法治疗。观察两组疗效及预后。结果观察组显效51.61%(16/31),总有效为96.77%(30/31),均显著高于对照组的25.81%(8/31)、80.65%(25/31);治疗后观察组舒张末期容积(223.3±43.2)与收缩末期容积(185.6±40.9)均显著小于对照组[(200.5±39.0)、(153.7±39.2)];治疗后两组患者心功能分级都有所改善,观察组(2.3±0.2)改善程度显著大于对照组(2.1±0.2);治疗后两组患者6 min行走距离均有所增加,观察组(391.3±111.3)增加程度显著多于对照组(446.6±100.3);以上差异均有统计学意义(均P<0.05)。结论比索洛尔、依那普利及螺内酯三联疗法对风湿性心脏病合并慢性心衰患者的疗效好,安全性高,值得推广。
Objective To study the efficacy and safety of bisoprolol, enalapril and spironolactone triple therapy in patients with rheumatic heart disease complicated with chronic heart failure. Methods From February 2010 to February 2015, 62 patients with rheumatic heart disease and chronic heart failure admitted to our hospital were enrolled. The patients were randomly divided into observation group (31 cases) and control group (31 cases). Control group for conventional treatment, the observation group with bisoprolol, enalapril and spironolactone triple therapy. The curative effect and prognosis of the two groups were observed. Results The observation group was 51.61% (16/31) and the total effective rate was 96.77% (30/31), which were significantly higher than that of the control group (25.81%, 80.65%, 25/31) The end-diastolic volume (223.3 ± 43.2) and end-systolic volume (185.6 ± 40.9) were significantly lower than those in the control group [(200.5 ± 39.0) and (153.7 ± 39.2)], respectively. (2.3 ± 0.2) was significantly higher than that of the control group (2.1 ± 0.2). After 6 minutes of treatment, the walking distance of both groups increased, the increase of the observation group (391.3 ± 111.3) was significantly more than that of the control group (446.6 ± 100.3) ); The above differences were statistically significant (all P <0.05). Conclusion Bisoprolol, enalapril and spironolactone triple therapy for rheumatic heart disease with chronic heart failure in patients with good efficacy, high safety, it is worth promoting.