螺内酯治疗老年高血压舒张性心力衰竭的疗效

Effects of spironolactone in treatment of elderly hypertensive patients with diastolic heart failure

目的：观察螺内酯对老年高血压舒张性心力衰竭(DHF)的临床疗效与机制。方法：入选老年高血压伴有DHF病人78例,随机分入螺内酯组(n=40)和对照组(n=38)。对照组采用常规治疗,螺内酯组加用螺内酯平均剂量47 mg·d^(-1),疗程6mo。在治疗前后检测血清Ⅲ型前胶原氨基端肽(PⅢNP)、脑钠肽(BNP)、6min步行试验及心脏超声。结果：治疗后螺内酯组6-min步行距离(559±s 62)m,较治疗前(318±41)m改善；与对照组(442±57)m比较有非常显著差异(P＜0．01)。2组治疗后左心室舒张功能超声指标优于治疗前,并优于对照组(P＜0．01)。结论：螺内酯治疗老年高血压DHF病人可改善心脏舒张功能,提高活动耐量。

AIM： To evaluate the clinical effect of spironolactone on diastolic heart failure in elderly hypertensive patients. METHODS： Seventy-eight elderly hypertensive patients with diastolic heart failure were randomized into two groups, treated group （n = 40, treated with spironolactone 47 mg·d^-1 and common drugs） and control group （n = 38, treated with common drugs） . The concentration of aminoterminal propeptide of type Ⅲ procollagen （PⅢP） and brain natriuretic peptide （BNP） were measured before and after 6 mo of treatments. Doppler ultrasound recordings and 6-min walk test were obtained from all patients to determine the left ventricular diastolic function. RESULTS： Within 6-min walk test, the patients of treated group could walk longer distance （559±62） m than before （318 ± 41） m and control group （442 ± 57） m, P〈 0.01. All left ventricular diastolic function data of treated group were better than those in control group （P 〈 0.01）. CONCLUSION： The spironolactone could improve the heart diastolic function and exercise tolerance in elderly hypertensive pa- tients with diastolic heart failure.