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本文对20例射血前期/左心室射血时间>0.46明确诊断为充血性心力衰竭的病人进行Captopril疗效观察。对于伴有肾功能衰竭及血压低于90/60mmHg的未纳入本实验。利用随机双盲法将病人分为两组,实验组给予Captopril 12.5mgq8h,对照组给予安慰剂。两组均给予常规剂量的强心利尿药,分别在服药前及服药后0.5、2、6、24、48、72、68小时测STIs各指标,并对总电机械收缩时间、射血前期、左心室射血时间用心率进行校正,观察其系列动态变化。服药前及服药后三日利用二维及多普勒超声心动图测定左心室射血分数及心室内径缩短率。结果表明Captopril具有明显的降低血压(收缩压及舒张压),相对减慢心率作用,从而降低心肌耗氧量,服药前后对比差异显著(P<0.001)。能够使射血前期/左心室射血时间降低,射血前期缩短,总电机械收缩时间,左心室收缩时间延长,与对照组比较差异极其显著(P<0.001)。左心室射血分数及左室内径缩短率服药后均有明显增加,同服药前比较差异显著(P<0.05)。我们认为STIs、二维及多普勒超声心动图为观察Captopril疗效提供了可靠指标,具有操作简单、灵敏度高、稳定性好等优点,其中射血前期/左心室射血分数为最重要的指标,直接反映了心脏功能状态,为临床提供了定量的心功能指标。
In this paper, 20 cases of pre-ejection / left ventricular ejection time> 0.46 patients diagnosed with congestive heart failure Captopril efficacy. For those with renal failure and blood pressure less than 90 / 60mmHg not included in this experiment. The patients were divided into two groups by randomized double-blind method. The experimental group was given Captopril 12.5mgq8h, and the control group was given placebo. The two groups were given conventional doses of cardiac diuretics, respectively, before taking the medication and 0.5,2,6,24,48,72,68 hours after taking the measured STIs of various indicators, and the total mechanical contraction time, pre-ejection, Left ventricular ejection time with heart rate correction, observe the series of dynamic changes. Left ventricular ejection fraction and ventricular diameter shortening were measured by two-dimensional and Doppler echocardiography before medication and three days after taking the medicine. The results showed that Captopril significantly reduced blood pressure (systolic and diastolic blood pressure), a relatively slow heart rate, thereby reducing myocardial oxygen consumption, before and after taking a significant difference (P <0.001). (P <0.001). Compared with the control group, the pre-ejection / left ventricular ejection time, pre-ejection duration, total mechanical contraction time and left ventricular systolic time were significantly increased. Left ventricular ejection fraction and left ventricular diameter shortening after taking the drug were significantly increased, compared with the medication before the significant difference (P <0.05). We believe that STIs, two-dimensional and Doppler echocardiography to provide reliable indicators for the observation of Captopril efficacy, with the advantages of simple operation, high sensitivity, good stability, etc., of which pre-ejection / left ventricular ejection fraction is the most important indicator , Directly reflects the state of cardiac function, provides a quantitative clinical cardiac function indicators.