資源描述：
《心衰教案-2008》由會員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在行業(yè)資料-天天文庫。
1、南方醫(yī)科大學(xué)南方醫(yī)院心血管內(nèi)科許頂立?冠心病占55.7%;?高血壓占13.9%;?風(fēng)濕性瓣膜病占8.9%;?擴(kuò)張性心肌病占7.5%?其他占14.0%Framingham的研究（1948年～1988年）：有癥狀的心力衰竭患者，男性患者平均存活時(shí)間為3.2年，女性為5.4年。中華心血管病雜志2002,30:7-23中華心血管病雜志2002,30:7-23中華心血管病雜志2002,30:7-23中華心血管病雜志2002,30:7-23NITRATESSURVIVAL0.7Placebo(273)0.6Prazosin(183)Hz+ISDN(186)
2、0.5PROBABILITY0.4OF0.3DEATH0.20.1006121824303642VHefT-1MONTHSNEnglJMed1986;314:1547DIGOXINn=3397NEnglJMed1991;325:1468-1475Followup:0.5~5.7year(average2.3years)ACEISURVIVAL0.80.7PlaceboPROBABILITY0.6p<0.001OFDEATH0.50.4p<0.002NYHAIV0.3127EnalaprilEnalapril126Placebo0.2(2.5~2
3、0mg,Bid)Follow-up:188d(1d~20mon)0.1CONSENSUS00123456789101112NEnglJMed1987;316:1429MONTHSACEISURVIVAL50p=0.0036Placebo40n=1284%30MORTALITYEnalapril20n=1285(2.5~10mg,Bid)n=2589CHF10-NYHAII-III-EF<350SOLVD(Treatment)0612182430364248NEnglJM1991;325:293MonthsACEISURVIVAL50p=0.30
4、Placebo40n=2117%30MORTALITY20Enalapriln=2111n=422810(2.5~10mg,Bid)NoCHFsymptomsEF<350SOLVD(Prevention)0612182430364248NEnglJMed1992;327:685MonthsACEISURVIVAL30AsymptomaticventricularPlacebodysfunctionpostMIn=111620Mortality,Captopril%n=111510n=22313-16dayspostAMIEF<402-19%12
5、.5---150mg/dayp=0.019SAVE001234NEnglJMed1992;327:669Years194metoprolol(10mg/day,To100~150mg/day)189PlaceboFollowup:12~18months34%Lancet1993;342:1441-1446MortalityCAPRICORN(Carvedilol)Atameanfollow-upof1year:Mortality11.0%placebogroup7.2%metoprololgroupwithsimilarrelativeredu
6、ctionsinsuddendeathanddeathduetoheartfailure.Lancet1999,353:2001-2007Uptitratedfrom3.125mgbidto25mgbidinintervalsofatleasttwoweeksFollowup:Mean10.4monthsNEnglJMed2001;344:1651-1658Followup:mean1.3yearFollowup:24months
