螺内酯对老年慢性心力衰竭患者心功能和血浆脑钠肽的影响

Effect of spironolactone on the cardiac function and plasma brain natriuretic peptide(BNP) in elderly patients with chronic heart failure

目的探讨螺内酯在老年慢性心力衰竭患者治疗中的作用。方法 62例老年慢性心力衰竭患者根据治疗方法不同分为常规组(30例)和螺内酯组(32例)。常规组:接受ACEI、洋地黄、噻嗪类利尿剂、β受体阻滞剂等常规治疗。螺内酯组:在常规治疗基础上口服螺内酯。观察各组患者在治疗前及治疗后4个月的血清BNP水平、LVEF、VE/VA,观察治疗后1个月的临床疗效。结果螺内酯组治疗后1个月的总有效率(90.6%)明显高于常规组(70%);螺内酯组治疗后LVEF、VE/VA较常规组明显升高(P<0.05)。2组治疗后血清BNP水平均较治疗前明显降低,螺内酯组降低更加明显(P<0.05)。结论螺内酯能明显改善老年慢性心力衰竭患者的心功能,降低血清BNP水平。

Objective To investigate the role of spironolactone in the treatment of chronic heart failure.Methods Sixty-two patients with chronic heart failure were divided into conventional group（n=30） and spironolactone group（n=32）.The conventional group received ACEI,digitalis, thiazide diuretics,β-blockers and other conventional treatments.Spironolactone group took oral spironolactone treatment in addition to the conventional treatment.Serum BNP levels,LVEF and VE/VA before and after 4 months of the treatment were observed.The treatment efficacy after 1 month of the treatment was observed as well.Results One month after treatment,the total efficiency（90.6%） of spironolactone group was significantly higher than that of the conventional group（70%）.LVEF and VE/VA of spironolactone group were significantly higher than those of the conventional group（P0.05）.After treatment,the serum BNP levels of both groups decreased.The spironolactone group had more significant decreases（P0.05）.Conclusion Spironolactone can significantly improve cardiac function and decrease serum BNP levels in elderly patients with chronic heart failure.