探讨国产坎地沙坦治疗充血性心力衰竭对运动耐量的影响.doc

探讨国产坎地沙坦治疗充血性心力衰竭对运动耐量的影响 【关键词】 充血性心力衰竭 【摘要】 目的 探讨血管紧张素Ⅱ受体拮抗剂国产坎地沙坦（Candesartan）治疗充血性心力衰竭(congestive heart failure)对运动耐量的影响。方法 选择符合充血性心力衰竭诊断的心功能为Ⅰ～Ⅲ级的患者共100例，根据年龄、性别、心功能随机分为2组，每组各50例。其中观察在常规治疗的基础上加用Candesartan；对照组仅采用常规治疗。分别于治疗前和治疗6个月后行运动心肺功能检测，检测气体代谢及做功指标。同时记录受试者的症状、体征及心功能分级。结果 观察组心衰复发住院率明显低于对照组（6.67%∶27.59%）。观察组与对照组比较最大摄氧量（Vo2max）明显增大（P＜0.01 ）；无氧阈(AT)明显增高（P＜0.01）；通气量（VE）明显增高（P＜0.05）；通气量（VE）/摄氧量（Vo2）增高（P＜0.05）；氧脉搏(O2Pulse)明显增高（P＜0.05）；最大心率明显增高（Ｐ＜0.01）；最大心率增值明显增高（Ｐ＜0.05）；运动时间明显延长（P＜0.01）；最大做功量（Wmax）明显增高（P＜0.01）；NYHA心功能分级平均改善0.5 级；症状和体征明显改善（P＜0.05）。结论 Candesartan通过改善左室重构和功能增加心脏射血量，进而改善心衰患者的运动耐量，减轻临床症状，降低再住院率的良好作用，从而为CHF的治疗提供了新的途径。 【关键词】 充血性心力衰竭； 运动耐量； 坎地沙坦； 运动心肺功能检测 To discuss effects of candesartan on exercise tolerace when it is used to treat congestive heart failure(CHF) FENG Su-ting，WANG Yan，YAN Sheng-min，et al. The First People’s Hospital，Baoding City，Hebei 071000，China 【Abstract】 Objective This article discusses the effect of candesartan-angiotensin Ⅱ receptor antagonists on exercise tolerace when it is used to treat congestive heart failure(CHF).Methods 100 patients were enrolled who with CHF and NYHA heart function class Ⅰ to Ⅲ degree grade. The patients were divided into two groups at random according to their age，sex，and pump function. There were 50 patients in each group. Observing groups had candesartan on the basis of the routine treatment; Control group only received the routine treatment. The patients of the two groups should have been examined with cardiopulmonary exercise test respectively six months before and after the treatment. Afterwards，we evaluated gas metabolism or work index. At the same time，we recorded the examinees’ symptom，physical sign and pump function grade.Results During the experiment two patients died，difference from observing group and control group each. Observing groups were apparently lower than control group in heart failure recurrence admission rate(6.67%：27.59%). Compared with control group，maximal oxygen uptake had obvious