醛固酮受体拮抗剂对慢性充血性心力衰竭疗效的影响

Effect of aldosterone receptor antagonist of on chronic congestive heart failure

目的观察醛固酮受体拮抗剂治疗慢性充血性心力衰竭(CHF)患者的临床疗效。方法 120例NYHA心功Ⅱ～Ⅳ级CHF住院患者随机分为治疗组和对照组各60例。对照组常规给予地高辛、速尿、卡托普利、倍他乐克治疗;治疗组在常规治疗基础上加用安体舒通20～40mg/d,连续用药12个月。用药前后分别进行多普勒超声心功能检查,定期测血压及行心电图、生化检查。结果两组有效率及死亡率比较有显著性差异(P<0.05),治疗后治疗组的多普勒超声心功能指标明显改善(P<0.05),血K+无显著性增高(P>0.05)。结论对CHF患者在常规治疗在基础上长期使用小剂量醛固酮受体拮抗剂治疗,安全有效,具有临床应用价值。

Objective To observe the aldosterone receptor antagonists treatment of chronic congestive heart failure（CHF） in patients by Doppler echocardiography.Methods 120 patients with NYHA cardiac function grade Ⅱ~Ⅳ hospitalized CHF patients were randomly divided into treatment and control groups.Normal control group given digoxin,furosemide captopril,metoprolol treatment;treatment group on the basis of conventional therapy plus spironolactone 20mg-40mg/d,continuous medication 12 months.Cardiac function before and after treatment effects were compared with Doppler ultrasound cardiac function examination,electrocardiogram and blood pressure regularly,biochemistry.Results Comparison of readmission and mortality rates were significantly different（P0.05）,the treatment group,heart function and the Doppler effect of cardiac function（P0.05）,blood K＋-free significantly increased（P0.05）.Conclusion Long-term use of low-dose aldosterone receptor antagonists is safe and effective for CHF.