氯沙坦联合螺内酯治疗对妊高症产后合并心衰患者心功能及血浆脑利钠肽的影响

Effects of Spironolactone and Losartan on Plasma Level of BNP and Cardiac Function of Patients With Pregnancy-Associated Hypertension Combined Heart Failure After Childbearing

目的观察氯沙坦联合螺内酯治疗妊高症产后合并心衰患者前后血浆脑钠肽与醛固酮的变化及临床意义。方法96倒妊娠高血压综合征产后合并心力衰竭患者均符合妊娠高血压性心脏病的诊断标准。按入院时间分为3组：氯沙坦单纯治疗组（L组）48例，氯沙坦和螺内酯联合治疗组（C组）48例。两组均于治疗前和治疗6个月时行心脏超声检查；两组于入院后（9±1）天及发病后3月、6月和12月分别测定血浆脑钠肽与醛固酮的浓度。结果与L组比较，C组血浆脑钠肽水平下降程度更明显（P〈0．05）。左室收缩和舒张末内径减小程度更明显（P〈0．05），左心室射血分数（LVEF）增加更明显（P〈0．05）。结论氯沙坦和螺内酯联合治疗妊高症产后合并心衰患者，可以更有效地降低血浆中BNP水平，增加LVEF、改善左室功能。

Objective To research the effect of Spironolactone and Losartan on the levels of plasma Brain Natriuretic Peptide（BNP） and Cardiac Function of Patients With Pregnancy-Associated Hypertension Combined Heart Failure after childbearing. Methods Sixty patients with Pregnancy- Associated Hypertension Combined Heart Failure after childbearing were randomly divided into two groups： losartan group（L group, n=48） use losaxtan only, and losartan combined with spironolactone group（C group, n=48）. Eehocardiographic indices were measured 6 months before and after treatment. Level of Plasma BNP was detected in （9±1） day and 3 months and 6 months after the treatment. Results： Compared with L group, level of BNP was significantly decreased in C group, Eehocardiographie indices were significantly improved in C group than in L group. Conclusion To treat patients with pregnancy-associated hypertension combined heart failure after childbearing by losartan combined with spironolactone, can decrease plasma BNP eoncentrations and improve cardiac function.