Hannachi N, Mechmèche R, Ayari M, Ben Ismail M
Service des Maladies Cardiovasculaires, Hôpital la Rabta, Tunis.
Ann Cardiol Angeiol (Paris). 1989 Jun;38(6):327-31.
The objective is here to study the long and intermediate term clinical and haemodynamic effects of enalapril during chronic heart failure resistant to the classic digitalis-diuretics treatment. The study involves 16 patients (12 males and 4 females), with a mean age of 50 years. Before being given enalapril, 12 patients were at stage IV and 4 patients at stage II of the NYHA; the mean capillary pressure was quite elevated (30 +/- 6.3 mmHg), the cardiac index has collapsed (2.12 +/- 0.38 l.min.m2) and the stroke fraction (SF) is 0.28 +/- 0.08. At the 1st month control, there is a definite functional and haemodynamic improvement of the pre-charge as well as the post-charge. This improvement is still present at 6 months. The ventricular function is improved (SF = 0.38 +/- 0.13; p less than 0.001). The clinical tolerance of enalapril is excellent and the only adverse reaction is a transient deterioration of the renal function in a patient with diabetic glomerulopathy.
本研究旨在探讨依那普利对经典洋地黄 - 利尿剂治疗无效的慢性心力衰竭患者的中长期临床及血流动力学影响。该研究纳入了16例患者（12例男性和4例女性），平均年龄为50岁。在给予依那普利之前，12例患者处于纽约心脏病协会（NYHA）心功能IV级，4例患者处于II级；平均毛细血管压显著升高（30±6.3 mmHg），心脏指数下降（2.12±0.38 l·min·m²），射血分数（SF）为0.28±0.08。在第1个月的对照检查中，静息及负荷后均出现了明确的功能和血流动力学改善。这种改善在6个月时仍然存在。心室功能得到改善（SF = 0.38±0.13；p＜0.001）。依那普利的临床耐受性良好，唯一的不良反应是1例糖尿病肾病患者出现短暂的肾功能恶化。
