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目的 探讨倍他乐克联合培哚普利治疗心力衰竭的有效而又安全的剂量。方法 充血性心力衰竭患者 98例 ,随机分为 4组 ,在常规治疗基础上 ,第一组给予倍他乐克 2 5mg/d,第二组倍他乐克2 5mg/d +培哚普利 2mg/d ,第三组倍他乐克 2 5mg/d +培哚普利 4mg/d ,第四组倍他乐克 5 0mg/d +培哚普利 4mg/d ,治疗 3个月后观察其疗效。 结果 ①第四组加药后 ,患者的心功能明显改善 ,左心室射血分数显著提高 (P <0 .0 5 ) ,并且存在剂量相关性 ,即随着药物剂量的增加 ,心功能改善及左心室射血分数增加愈显著 (P <0 .0 1)。②培哚普利首剂 2mg ,1次 /d ,与未加用培哚普利者比较 ,首剂血压反应相同 ,维持剂量 4mg后也未发生过度血压下降。③各组间死亡人数及不能耐受人数无明显差异。结论 应用合理剂量的倍他乐克联合培哚普利治疗充血性心力衰竭可有效控制患者的临床症状 ,明显改善心功能。
Objective To investigate the effective and safe dose of metoprolol combined with perindopril in the treatment of heart failure. Methods A total of 98 patients with congestive heart failure were randomly divided into 4 groups. On the basis of conventional treatment, the first group received metoprolol 25mg / d, the second group metoprolol 25mg / d + perindopril 2mg / d, the third group of metoprol 25mg / d + perindopril 4mg / d, the fourth group of metoprolol 50mg / d + perindopril 4mg / d, after 3 months of treatment observed Its efficacy. Results ① In the fourth group, the cardiac function of the patients was significantly improved and the left ventricular ejection fraction was significantly increased (P <0.05), and there was a dose-related effect. With the increase of the dose of the drug, the cardiac function improved and Left ventricular ejection fraction increased more significantly (P <0.01). ② The first dose of perindopril 2mg, 1 time / d, compared with no added perindopril, the first dose of blood pressure the same, maintaining the dose of 4mg nor excessive blood pressure did not decline. ③ There was no significant difference between the number of deaths and the number of intolerant persons in each group. Conclusion The application of a reasonable dose of metoprolol combined with perindopril in patients with congestive heart failure can effectively control the clinical symptoms and improve the cardiac function.