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目的：观察氯沙坦治疗充血性心力衰竭(CHF)的临床疗效。方法：40例经常规洋地黄、利尿剂、血管扩张药等治疗效果欠佳的CHF患者，给予口服氯沙坦25～100(50±15)mg/d，治疗4～6周。观察治疗前后心率、心胸比、血压、左室舒张末期内径、左室射血分数以及心功能的变化。结果：治疗后心率、血压、心胸比以及左室舒张末期内径均明显下降（P＜0.05、＜0.01）。左室射血分数增加（P＜0.01），心功能改善1～2级。药物副作用少，患者耐受性好。结论：氯沙坦治疗CHF疗效好，副作用少，值得临床推广。“,”Objective: To observe the effect of losartan in treating patients with refractory heart failure.Method:Fourty patients 〔male 25,female 15,average age (61±11)〕 with heart failure 〔cardiac function (NYHA) grade Ⅲ 14 patients ,grade Ⅳ 26 patients〕,who had unsatisfactory results under conventional digitals,diuretics,vasodilators therapy,were given losartan (angiotensin Ⅱ receptor inhibitor) 25～100 mg 〔average does (50±15) mg〕 orally once a day for 4～6 weeks.The changes of heart rate (HR),blood pressure(BP), cardiothoracic ratio,left ventricular end diastolic diameter(LVEDD), left ventricular ejection fraction (LVEF) and cardiac function (NYHA) were observed.Result: After 4～6 weeks therapy,HR,BP,cardiothoracic ratio and LVEDD all decreased significaently (P<0.05,P<0.01);LVEF increased (P<0.01); cardiac function (NYHA) improved 1～2 grade.Losartan had few adverse effects and patients′tolerance was perfect.Conclusion:The effect of losartan in treating patients with refractory heart failure is satisfactory. It has few adverse effects.