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目的 :探讨在慢性充血性心力衰竭常规治疗的基础上 ,加用单硝酸异山梨酯片和依钠普利片的疗效是否优于单加依钠普利 ,是否能进一步提高心功能。方法 :将 16 4例慢性心衰患者随机分为A组和B组、A组在用利尿剂、强心剂、ACEI和依那普利的基础上加用单硝酸异山梨酯 ,B组采用利尿剂、强心剂、ACEI和依那普利 ,治疗 12周 ,观察临床症状的改善情况 ,应用超声心动图测定左室射血分数并进行对比分析。结果 :两组病人用药后心功能明显改善 ,射血分数明显提高 ,A组由治疗前的 0 35± 0 0 6提高到 0 6 1± 0 12 ,B组由治疗前的 0 2 8± 0 0 4提高到 0 39± 0 0 8,组间比较有显著性差异(P <0 .0 5 ) ;临床症状改善总有效率A组为 91% ,B组为 81% ,组间比较P <0 .0 5。结论 :单硝酸异山梨酯片与依钠普利片合用治疗慢性心衰患者的临床疗效优于单加依钠普利
OBJECTIVE: To investigate whether the effect of adding isosorbide mononitrate tablets and epristeride tablets on the basis of conventional treatment of chronic congestive heart failure is superior to that of enalapril alone, so as to further improve the cardiac function. Methods: One hundred and sixty-four patients with chronic heart failure were randomly divided into group A and group B. Group A was given isosorbide mononitrate on the basis of diuretic, cardiotonics, ACEI and enalapril, and diuretics , Cardiotonics, ACEI and enalapril for 12 weeks. The improvement of clinical symptoms was observed. The left ventricular ejection fraction was measured by echocardiography and compared. Results: After treatment, the two groups of patients’ cardiac function improved significantly and the ejection fraction increased significantly from 0 35 ± 0 0 6 before treatment to 0 6 1 ± 0 12 in group A, and from 0 28 ± 0 0 before treatment in group B (P <0.05). The total effective rate of clinical symptom improvement was 91% in group A and 81% in group B, P < 0 .0 5. CONCLUSION: The clinical efficacy of isosorbide mononitrate tablets in combination with ipsapril tablets in the treatment of patients with chronic heart failure is superior