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关键词 特拉唑嗪 充血性心力衰竭 陈旧性心肌梗死
【文献标识码】 A 【文章编号】 1606-8106(2003)13-1957-02
Curative effect of a small dose of terazosin on old
myocardial infarction complicated with chronic congestive heart failure
Luo Yun,Yan Dechun,Wang Xialian
Taikang Hospital,Beijing100043.
【Abstract】 Objective To observe the effects of low close of terazosin onold myocardial infarction complicatˉed with chronic congestive heart failure.Methods Ninety-six old myocardial infarction patients with severe chronic congestive heart failure were randomly divided into two groups:group A(terazosin group)and group B(control group).Group B only got conventional therapy.Besides conventional treatment,patients in group A took1mg terazosin per evening.Patients were followed up for6month.Results The results showed that both groups had a significant imˉprovement in NYHA class,decrease in left ventricular end-diastolic volume and end-systolic volume,and significant increase of left ventricular ejection fraction.The increase of LVEF and decrease of LVESV and LVEDV in group A was more significant than in group B.Conclusion It is concluded that a small dose of terazosin is beneficial in improving left ventricular function in OMI patientswith-severe chronic congestive heart failure.
Key words terazosin congestive heart failure old myocardial infarction
陈旧性心肌梗死(OMI)容易合并心功能不全,其1年的总死亡率为9%~12%,5年死亡率男性为62%,女性为42%,因此,对心功能不全的治疗也是当前的重要临床课题之一。特拉唑嗪作为新型α受体阻滞剂已用于治疗心功能不全及高血压病,但是用于治疗慢性充血性心力衰竭的报道不多。为此,我们观察小剂量特拉唑嗪口服辅助治疗OMI合并充血性心力衰竭的疗效。
1 资料与方法
1.1 病例选择 将2000~2002年住院和门诊治疗96例OMI合并心功能不全的病人随机分为两组:A组48例为治疗组,B组48例为对照组。
1.2 方法 入选的病人均统计性别、年龄、有无高血压病史及糖尿病史、心肌梗死病史、梗死部位。A组病人除接受心力衰竭的常规治疗(包括利尿、地高辛及开博通等)、抗高血压治疗和糖尿病的治疗外,加用特拉唑嗪1mg,每晚1次,口服;B组未使用特拉唑嗪口服,其它治疗同A组。统计两组治疗前及治疗6个月时NYHA心功能分级和LVESV、LVEDV和LVEF,采用东芝SSA-340A型彩色二维超声心动图(2-DE)测定。
2 结果
2.1 两组病人的临床特征 见表1。各参数之间的比较差异均无显著性(P>0.05)。表1两组病人的一般临床特征
2.2 两组治疗前后NYHA心功能分级 见表2。A、B组治疗前后的心功能分别为3.6级和3.5级,治疗后分组减至2.5和2.7级(P均<0.001)。组间比较可以看出,A组的改善倾向较B组明显。在6个月随访期间,病人无一例死亡。
2.3 两组病人心腔大小及LVEF比较 见表3。从2-DE的检查结果可以看出,治疗前后两组的LVEDV和LVESV明显减小,而LVEF显著增加。治疗前两组之间各参数的比 较差异均无显著性,但治疗后各组参数均出现差异显著性,即A组的改善较B组更明显。表2 两组病人治疗前后NYHA分级的比较表3 两组治疗前后的LVEVD、LVESV、LVEF的比较 (ˉx±s)注:同组治疗前后比较 ˇ P<0.05, ˇˇ P<0.01, ˇˇˇ P<0.001