ABSTRACT
OBJECTIVE:To observe the clinical efficacy and safety of candesartan cilexetil combined with hydrochlorothiazide in the treatment of elderly degenerative valvular heart disease heart failure. METHODS:120 patients with elderly degenerative val-vular heart disease heart failure were randomly divided into observation group,control group 1 and control group 2. All patients were given conventional treatment,including limited activity,limited salt,limited water,additional use of digitalis and nitrates car-diac drugs,etc. On this basis,observation group was orally treated with Candesartan cilexetil dispersible tablet 4 mg,once a day+Hydrochlorothiazide tablet 25 mg,once a day,took 10 d then stopped 2 d;control group 1 was orally treated with Enalapril male-ate tablet 10 mg,once a day+Hydrochlorothiazide tablet;control group 2 was orally treated with Metoprolol tartrate tablets 50 mg, twice a day+Hydrochlorothiazide tablet. All efficacies of patients were evaluated after one year,and the BNP,LVEF,LVEDD and SV before and after treatment,medication compliance and incidence of adverse reactions were observed. RESULTS:There was no significant difference in the total effective rate in each group(P>0.05). After treatment,the BNP and LVEDD were significantly lower than before,LVEF and SV were significantly higher than before,with significant difference(P0.05). CONCLUSIONS:Based on the conventional treatment,can-desartan cilexetil combined with hydrochlorothiazide has good clinical efficacy and safety in the treatment of elderly degenerative valvular heart disease heart failure.
ABSTRACT
Objective To observe the clinical effect and safety oflevosimendan in the treatment of intractable heart failure.Methods One hundred cases of patients with intractable heart failure and cardiac function in NYHA Ⅲ-Ⅳwere enrolled,and the patients were randomly divided into levosimendan group and control group by random digits table method,50 cases in each group.The two groups were given conventional anti heart failure treatment,levosimendan group was treated with levosimendan treatment,control group continued to be given conventional anti heart failure treatment.The left ventricular ejection fraction (LVEF),plasma brain natriuretic peptide (BNP),stroke volume (SV),cardiac output (CO),cardiac index (CI) changes after 12 d of two groups were observed.Results The total effective rate of the levosimendan group was significantly higher than that of the control group [88％ (44/50) vs.42％ (21/50)],the difference was statistically significant (P ＜ 0.05).The two groups before treatment,plasma BNP,LVEF,SV,CO,CI were not significant (P ＞ 0.05).The two groups after treatment of plasma BNP,LVEF,SV,CO,CI were significantly improved than before treatment [levosimendan group:(1 621.3 ± 1 302.1) ng/L vs.(6 530.3 ± 1 620.2) ng/L,(54.7 ± 8.9)％ vs.(38.5 ± 8.7)％,(89.7 ± 8.5) ml vs.(67.1 ± 13.6) ml,(5.30 ±1.60) L/min vs.(3.65 ±2.10) L/min,4.65 ±0.92 vs.2.82 ±0.95; control group:(4 251.2 ± 1 581.3) ng/L vs.(6 495.5 ± 1 640.4) ng/L,(52.6 ± 8.0)％ vs.(39.1 ± 9.2)％,(76.5 ± 8.9)ml vs.(66.4 ± 13.9) ml,(4.36 ± 2.37) L/min vs.(3.71 ± 2.35) L/rmin,3.11 ± 0.73 vs.2.87 ± 0.96],and the levosimendan group improved more obviously,the differences were statistically significant (P ＜ 0.05).The incidence of adverse reactions between two groups had no significant difference (P ＞ 0.05).Conclusion Levosimendan can significandy improve cardiac function in patients with intractable heart failure,increase LVEF,SV,CO and CI,and decrease plasma BNP,and it is safe and reliable.