卡托普利治疗高龄患者慢性心力衰竭

Captopril treatment of chronic heart failure in the very old.

作者信息

De Bock V, Mets T, Romagnoli M, Derde M P

机构信息

Department of Geriatrics, Academic Hospital, Free University of Brussels (V.U.B.), Belgium.

出版信息

J Gerontol. 1994 May;49(3):M148-52. doi: 10.1093/geronj/49.3.m148.

DOI:10.1093/geronj/49.3.m148

PMID:8169337

Abstract

BACKGROUND

The safety and efficacy of angiotensin-converting enzyme inhibitors for very old patients with chronic heart failure have been less well documented than for younger patients.

METHODS

A prospective, randomized double-blind, placebo-controlled study of captopril, 25 mg twice daily, was designed. Fifty patients (mean age 84.2 +/- 5.2) participated. The degree of chronic heart failure (according to the Boston Study Group rating), the distance walked in 6 minutes, and the occurrence of uncontrolled heart failure and adverse reactions were used as main outcome measures.

RESULTS

Significantly more patients receiving placebo developed uncontrolled heart failure than patients receiving captopril (p = .022). In an intention to treat analysis, the first and last evaluations of the degree of chronic heart failure were compared. A significantly different evolution was observed between the two treatment groups (p < .001), with a significant improvement only in the captopril-treated patients (p < .001). The distance walked in 6 minutes improved significantly only in the captopril group (p = .004). The only adverse reaction was rash in two patients receiving captopril.

CONCLUSIONS

The study gives further evidence that angiotensin-converting enzyme inhibitor treatment for very old patients with chronic heart failure is useful.

摘要

背景

与年轻患者相比，血管紧张素转换酶抑制剂用于老年慢性心力衰竭患者的安全性和有效性的文献记载较少。

方法

设计了一项前瞻性、随机双盲、安慰剂对照研究，使用卡托普利，每日两次，每次25毫克。50名患者（平均年龄84.2±5.2岁）参与。慢性心力衰竭程度（根据波士顿研究组评级）、6分钟步行距离、失代偿性心力衰竭的发生情况和不良反应作为主要结局指标。

结果

接受安慰剂的患者发生失代偿性心力衰竭的人数显著多于接受卡托普利的患者（p = 0.022）。在意向性分析中，比较了慢性心力衰竭程度的首次和末次评估。两个治疗组之间观察到显著不同的变化（p < 0.001），仅卡托普利治疗的患者有显著改善（p < 0.001）。仅卡托普利组的6分钟步行距离有显著改善（p = 0.004）。唯一的不良反应是两名接受卡托普利治疗的患者出现皮疹。