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苯钠普利联合生脉注射液治疗顽固性心力衰竭32例

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陕西医学杂志 2006年第3期35卷 342-343页

作者：宋宜生陈丹谢学建中国西电集团医院西安710077 第四军医大学西京医院心内科

我们对32例顽固性心力衰竭采用了中药生脉注射液联合用转换酶抑制剂(ACEI)苯钠普利治疗,取得了较为满意的疗效,现总结如下。[第一段]

关键词：心力衰竭/药物疗法血管紧张素转换酶抑制药/治疗应用生脉注射液

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坎地沙坦联合贝那普利治疗心力衰竭43例

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陕西医学杂志 2008年第12期37卷 1664-1666页

作者：高晖西安市第四医院心内科西安710004

目的:探讨坎地沙坦联合贝那普利治疗充血性心力衰竭(CHF)的疗效。方法:在心衰常规治疗的基础上实验组43例患者给予贝那普利10mg/d,坎地沙坦4mg/d,对照组43例给予贝那普利10mg/d,8周后评价左室射血分数(LVEF)、左室舒张末期内径变化(LVED... 详细信息

目的:探讨坎地沙坦联合贝那普利治疗充血性心力衰竭(CHF)的疗效。方法:在心衰常规治疗的基础上实验组43例患者给予贝那普利10mg/d,坎地沙坦4mg/d,对照组43例给予贝那普利10mg/d,8周后评价左室射血分数(LVEF)、左室舒张末期内径变化(LVEDD),测定血清钾,血清肌酐等指标。结果:实验组左室射血分数提高,左室舒末内径缩小,同时血钾、肌酐等指标未见明显异常。结论:同时应用坎地沙坦和贝那普利较单用贝那普利更能改善CHF患者的心功能,而对血清钾,血清肌酐等指标无明显影响。

关键词：心力衰竭充血性/药物疗法血管紧张素转换酶抑制药/治疗应用受体血管紧张素/治疗应用

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氟伐他汀联用苯那普利治疗2型糖尿病并发冠心病患者108例

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陕西医学杂志 2006年第12期35卷 1692-1693页

作者：王清金殷植徐冬岩吉林大学中日联谊医院内分泌科长春130031

大约70%的2型糖尿病(T2DM)死于心血管并发症。其中至少一半死于冠心病。尤其是无症状性心肌缺血(SMI)容易被忽视,T2DM患者存在一定神经病变,对心肌缺血表现不明显,SMI更易被忽视,而且有可能是急性心肌梗死或猝死的先兆。我们于2003年6月... 详细信息

大约70%的2型糖尿病(T2DM)死于心血管并发症。其中至少一半死于冠心病。尤其是无症状性心肌缺血(SMI)容易被忽视,T2DM患者存在一定神经病变,对心肌缺血表现不明显,SMI更易被忽视,而且有可能是急性心肌梗死或猝死的先兆。我们于2003年6月至2004年6月观察了采用他汀类降脂药氟伐他汀及血管紧张素转换酶抑制剂(ACEI)类降压药物苯那普利治疗老年T2DM并SMI患者,探讨苯那普利对T2DM并SMI患者的疗效。[第一段]

关键词：糖尿病,非胰岛素依赖型/并发症冠状动脉疾病/药物疗法 @氟代他汀血管紧张素转换酶抑制药/治疗应用

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盐酸咪哒普利和螺内酯治疗慢性充血性心力衰竭61例

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陕西医学杂志 2007年第4期36卷 499-500页

作者：方伟郑州大学第五附属医院心内科郑州450003

盐酸咪哒普利为血管紧张素转换酶抑制剂(ACEI),降压方面报道较多,改善心功能方面报道尚少.螺内酯为醛固酮拮抗剂,本研究旨在探讨两药合用对心功能的影响,现报道如下。[第一段]

关键词：心力衰竭充血性/药物疗法血管紧张素转换酶抑制药/治疗应用醛固酮拮抗剂/治疗应用

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氯沙坦联合苯那普利治疗高血压左室肥厚60例

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陕西医学杂志 2006年第8期35卷 1015-1016页

作者：高鸿山高焕萍杨万勇山东枣庄矿业集团公司中心医院心内科枣庄277011

高血压所致左室肥厚(Left ventricular hypertrophy,LVH)是心血管事件的独立危险因子,其心血管疾病死亡较无LVH者增加8倍。因此,在有效降压的同时逆转LVH应是治疗高血压病的重要目标之一。本研究旨在观察血管紧张素Ⅱ(AngiotensinⅡ,Ang... 详细信息

高血压所致左室肥厚(Left ventricular hypertrophy,LVH)是心血管事件的独立危险因子,其心血管疾病死亡较无LVH者增加8倍。因此,在有效降压的同时逆转LVH应是治疗高血压病的重要目标之一。本研究旨在观察血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)受体拮抗剂氯沙坦联合血管紧张素转换酶抑制剂(Angiotensin conversion enzyme inhibitor,ACEI)苯那普利的降压疗效以及对LVH的影响。[第一段]

关键词：高血压/并发症肥大,左心室/药物疗法 @氯沙坦血管紧张素转换酶抑制药/治疗应用

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苯那普利对原发性高血压患者血清TGF-β1的影响及意义

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陕西医学杂志 2005年第12期34卷 1501-1503页

作者：朱新业牛小麟高登峰王子颖柏灵西安交通大学第二医院急诊科西安710004 西安交通大学第二医院心内科西安710004

目的:观测苯那普利对原发性高血压(EH)患者血清TGF-β1水平的影响及其与左室肥厚(LVH)和心肌纤维化的关系。方法:26例经超声心动图检查确诊为EH伴LVH患者,给予苯那普利治疗24周。治疗前、治疗后12周和24周分别测算左室重量指数(LVMI),... 详细信息

目的:观测苯那普利对原发性高血压(EH)患者血清TGF-β1水平的影响及其与左室肥厚(LVH)和心肌纤维化的关系。方法:26例经超声心动图检查确诊为EH伴LVH患者,给予苯那普利治疗24周。治疗前、治疗后12周和24周分别测算左室重量指数(LVMI),测定转移生长因子-β1(TGF-β1)、血清型前胶原(PC)、透明质酸(HA)、层粘蛋白(LN)。并与对照组(28例)比较。结果:苯那普利治疗12周,LVMI从147.5±18.6降至131.7±20.4(P<0.05),治疗24周,LVMI改善更明显(P<0.01)。治疗前、后TGF-β1明显降低(P<0.01)。PC、HA、LN在EH伴LVH组均高于对照组。治疗24周,PC、LN下降明显(P<0.01)。TGF-β1与血清PC、LN与LVMI均呈正相关(P<0.05)。结论:苯那普利长期治疗能减轻EH患者LVH,同时减少心肌纤维化程度。

关键词：高血压/药物疗法血管紧张素转换酶抑制药/治疗应用转化生长因子β

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益气活血汤加洛汀新对糖尿病肾病24小时尿蛋白、血肌酐及血尿素氮影响的临床观察

益气活血汤加洛汀新对糖尿病肾病24小时尿蛋白、血肌酐及血尿素氮...

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作者：张丽霞福建中医学院

学位级别：硕士

目的：寻求延缓糖尿病肾病肾功能恶化的中西医结合治疗的有效方法。方法：将60例病例随机分为A组及B组。两组在年龄、性别、24小时尿蛋白定量和血肌酐经统计学处理，未见显著差异。经饮食、运动及降糖药物治疗，有效严格地控制血糖... 详细信息

目的：寻求延缓糖尿病肾病肾功能恶化的中西医结合治疗的有效方法。方法：将60例病例随机分为A组及B组。两组在年龄、性别、24小时尿蛋白定量和血肌酐经统计学处理，未见显著差异。经饮食、运动及降糖药物治疗，有效严格地控制血糖，空腹血糖＜7.0mmol／L者，糖基化血红蛋白＜8％的情况下。A组为洛汀新治疗对照组，B组为益气活血汤+洛汀新组。治疗时间2个月，检测治疗前后24小时尿蛋白定量、Scr及血尿素氮(BUN)水平，观察指标用均数±标准差((?)±s)表示，治疗前后用成对t检验及组间对照用t检验。结果：洛汀新组、益气活血汤+洛汀新组治疗前后Scr水平均无显著差异(p＞0.05)。洛汀新、益气活血汤+洛汀新组治疗后见尿蛋白定量的下降，有统计学意义(p＜0.05)。两组间比较，益气活血汤+洛汀新组降低尿蛋白的疗效明显优于洛汀新(p＜0.05)。结论：中西医治疗在延缓糖尿病肾病肾功能恶化，改善患者生活质量方面疗效优于单用ACEI。

关键词：糖尿病肾病/中西医结合疗法补益药/治疗应用活血药/治疗应用血管紧张素转换酶抑制药/治疗应用蛋白尿/血液肌酸酐/血液血尿素氮/血液

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Modulation of in vivo cardiac hypertrophy with insulin-like growth factor-1 and angiotensin-converting enzyme inhibitor: Relationship between change in myosin isoform and progression of left ventricular dysfunction

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第2期36卷 635-+页

作者： Iwanaga, Y Kihara, Y Yoneda, T Aoyama, T Sasayama, S Kyoto Univ Grad Sch Med Dept Cardiovasc Med Sakyo Ku Kyoto 6068507 Japan

OBJECTIVES Supplemental myocardial hypertrophy induced by insulin-like growth factor (IGF)-1 may prevent transition from hypertrophy to heart failure under chronic mechanical overload. BACKGROUND Several studies have suggested that IGF-1 treatment may be beneficial in chronic heart failure. In addition, recent studies indicated that the amount of cu-myosin heavy chain (MHC) plays a significant hemodynamic role in large animals including humans. METHODS We treated Dahl salt-sensitive hypertensive rats on a long-term basis with IGF-1. The effects were compared with those produced by treatment using a sub-antihypertensive dose of temocapril, an angiotensin-converting enzyme (ACE) inhibitor. At 11 weeks, when these rats displayed compensated left ventricular hypertrophy (LVH), they were randomized to three groups: 1) TGF group (3 mg/kg/day);2) temocapril group (1 mg/kg/day);and 3) vehicle (control) group. RESULTS After 15 weeks, the control rats showed left ventricular (LV) enlargement and severe LV dysfunction and rapidly died of pulmonary congestion (mean survival time: 16.8 +/- 0.5 weeks). The survival time was significantly shortened (15.6 +/- 0.3 weeks) in the IGF-1 group but significantly prolonged (19.5 +/- 0.6 weeks) in the temocapril group. The rats in the IGF-1 group showed accelerated LV dilation and dysfunction. Of the several parameters investigated, it was found that the relative amounts of MHC isoforms differed among the three groups. The alpha-MHC mRNA level was decreased by 52% (p < 0.01) in the IGF group, while it increased by 58% (p < 0.01) in the temocapril group compared with the control group. These changes were related to the progression of LV dysfunction. CONCLUSIONS Supplemental myocardial hypertrophy with long-term IGF-1 treatment may not be beneficial if concentric LVH already exists. Our data suggest that IGF-1 may not protect myocardial performance when its hypertrophic effect aggravates the reduction of alpha-MHC. By contrast, the ACE inhib

关键词：血管紧张素转换酶抑制药/治疗应用心脏扩大/预防和控制评价研究(主题) 胰岛素样生长因子Ⅰ/治疗应用心肌/化学肌球蛋白重链/分析随机分配大鼠近交系硫氮杂|艹卓|类/治疗应用心室功能障碍左动物男(雄)性大鼠

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Reliability, validity, and responsiveness of the six-minute walk test in patients with heart failure

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AMERICAN HEART JOURNAL 2001年第4期142卷 698-703页

作者： Demers, C McKelvie, RS Negassa, A Yusuf, S Hamilton Hlth Sci Corp Gen Div Div Cardiol Prevent Cardiol & Therapeut Res Program Hamilton ON L8L 2X2 Canada McMaster Univ Hamilton ON Canada Albert Einstein Coll Med Dept Epidemiol & Social Med Bronx NY 10467 USA

Background Our purpose was to evaluate the reliability, validity, and responsiveness of the 6-minute walk test (6MWT) in patients with heart failure (HF) enrolled in the Randomized Evaluation of Strategies for Left Ventricular Dysfunction (RESOLVD) pilot study. Methods A total of 768 patients was enrolled in a multicenter randomized clinical trial evaluating the effect of candesartan, enalapril, and metoprolol on left ventricular ejection fraction (LVEF), 6MWT distance, neurohormones, and quality of life. The 6MWT was performed once at screening and twice at baseline, 18 weeks, and 43 weeks by a standardized method. Results Test-retest reliability at baseline (intraclass correlation coefficient [ICC] = 0.90), 18 weeks (ICC = 0.88), and 43 weeks (ICC = 0.91) was very good. Baseline 6MWT distance was weakly inversely correlated to the quality-of-life cumulative score (r = -0.26, P = .0001) and moderately inversely correlated to the New York Heart Association functional classification (NYHA-FC) (r = -0.43, P = .001). In the RESOLVD study, the 6MWT was not responsive to change when effect sizes and standardized response means were used. Disease-specific quality of life was responsive to change in patients treated with candesartan and enalapril and NYHA-FC was responsive to change in the candesartan and enalapril combination and for enalapril alone with small effect sizes. The 6MWT, NYHA-FC, and quality of life were not responsive to change during the metoprolol or placebo phase. Conclusions The 6MWT is highly reproducible in patients with symptoms of HF. It is somewhat correlated to NYHA-FC and quality of life. Overall, quality of life was most responsive to change, whereas 6MWT and NYHA-FC were comparable but less responsive to change in the RESOLVD study.

关键词：血管紧张素转换酶抑制药/治疗应用抗高血压药/治疗应用苯咪唑类/治疗应用药物疗法联合依那普利/治疗应用运动试验/统计学和数值数据健康状况心力衰竭/诊断心力衰竭/药物疗法美托洛尔/治疗应用试点项目生活质量问卷调查可重复性结果疾病影响状态调查每搏输出量/药物作用四唑类/治疗应用治疗结果心室功能左/药物作用步行/统计学和数值数据女(雌)性人类男(雄)性中年人

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Aspirin and mortality in patients treated with angiotensin-converting enzyme inhibitors - A cohort study of 11,575 patients with coronary artery disease

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 1999年第7期33卷 1920-1925页

作者： Leor, J Reicher-Reiss, H Goldbourt, U Boyko, V Gottlieb, S Battler, A Behar, S Ben Gurion Univ Negev Dept Cardiol Soroka Med Ctr Fac Hlth Sci IL-84105 Beer Sheva Israel Tel Aviv Univ Neufeld Cardiac Res Inst Tel Hashomer Israel

OBJECTIVE The purpose of this study was to investigate the significance of the possible negative interaction between aspirin and angiotensin-converting enzyme (ACE) inhibitors. BACKGROUND Several provocative reports have recently suggested that aspirin is unsafe in patients with heart failure and has negative interaction with ACE inhibitors that might attenuate their beneficial effects upon survival. METHODS We analyzed mortality data of 11,575 patients with coronary artery disease screened for the Bezafibrate Infarction Prevention trial. A total of 1,247 patients (11%) were treated with ACE inhibitors. Of them, 618 patients (50%) used aspirin. RESULTS Five-year mortality was lower among patients on ACE inhibitors and aspirin than patients on ACE inhibitors without aspirin (19% vs. 27%;p < 0.001). After adjusting for confounders, treatment with aspirin and ACE inhibitors remained associated with lower mortality risk than using ACE inhibitors only (relative risk [RR] = 0.71;95% confidence interval [CI] = 0.56 to 0.91). Subgroup analysis of 464 patients with congestive heart failure treated with ACE inhibitors revealed 221 patients (48%) on aspirin and 243 patients not on aspirin. Although clinical characteristics and therapy were similar, patients taking aspirin experienced lower mortality than patients who did not (24% vs. 34%;p 0.001). After adjustment, treatment with aspirin was still associated with lower mortality (RR = 0.70;95% CI = 0.49 to 0.99). CONCLUSIONS Among coronary artery disease patients with and without heart failure who are treated with ACE inhibitors, the use of aspirin was associated with lower mortality than treatment without aspirin. Our findings contradict the claim that aspirin attenuates the beneficial effect of ACE inhibitors and supports its use in patients with coronary artery disease treated with ACE inhibitors. (C) 1999 by the American College of Cardiology.

关键词：血管紧张素转换酶抑制药/治疗应用阿司匹林/治疗应用卡托普利/治疗应用冠心病/药物疗法冠心病/死亡率交叉研究药物相互作用药物疗法联合依那普利/治疗应用心力衰竭/药物疗法心力衰竭/死亡率以色列/流行病学血小板聚集抑制剂/治疗应用登记/统计学和数值数据危险因素存活率女(雌)性人类男(雄)性中年人

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