Tkaczewski W, Adamska-Dyniewska H, Bała T, Gajewska B, Chojnowska-Jezierska J, Rosiek S, Słomka S
III Kliniki Chorób Wewnetrznych IMW WAM, Lodzi.
Pol Tyg Lek. 1993;48(14-15):318-20.
Captopril was administered to 50 carefully selected patients with severe circulatory failure (18 patients classified as class III and 32 as class IV according to NYHA) in daily dose of 37.5-75 mg for two years. Patients were also given digoxin, diuretic agents and iso-dinitrosorbide. Clinical improvement increased with duration of captopril therapy. A significant improvement following the correction of therapy was achieved in 15% of patients, following one month in 28%, three months--in 70%, and after 1 and 2 years in 84% of the treated patients. All patients survived for one year, and 44--for two years (88%). Clinical improvement was manifested by: diminished of dyspnoea, edema, pulmonary and liver congestion, increase in left ventricle ejection fraction, change of disease staging by one or two NYHA classes, and reduced ventricular rate during atrial fibrillation (in 30% of patients within one year). More noticeable improvement was seen in patients with baseline ejection fraction > 40% than those with EF < 30%, in hypertensive patients than normotensive, and in patients classified to III NYHA class. Ejection fraction increased from 37.9 +/- 9.2% before the treatment to 54.6 +/- 7.7% after a two-year captopril therapy (p < .01). Captopril greatly contributes to the successful therapy of the chronic severe heart failure.
对50例精心挑选的重度循环衰竭患者（根据纽约心脏协会分级，18例为III级，32例为IV级）给予卡托普利治疗，日剂量为37.5 - 75毫克，为期两年。患者同时还服用地高辛、利尿剂和异山梨醇二硝酸酯。临床改善情况随卡托普利治疗时间的延长而增加。治疗调整后，15%的患者有显著改善，治疗1个月后为28%，3个月后为70%，治疗1年和2年后分别为84%。所有患者均存活1年，44例存活2年（88%）。临床改善表现为：呼吸困难、水肿、肺和肝淤血减轻，左心室射血分数增加，疾病分级改善1或2个纽约心脏协会级别，房颤时心室率降低（1年内30%的患者）。基线射血分数>40%的患者比射血分数<30%的患者改善更明显，高血压患者比血压正常者改善更明显，纽约心脏协会III级患者改善更明显。射血分数从治疗前的37.9±9.2%增加到卡托普利治疗两年后的54.6±7.7%（p<.01）。卡托普利对慢性重度心力衰竭的成功治疗有很大贡献。
