卡维地洛联合利尿剂对轻、中度心功能不全患者BNP及心功能影响研究

Study on influence of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency

目的探讨卡维地洛联合利尿剂对轻、中度心功能不全患者BNP及心功能影响。方法对2014年6月~2016年6月于浙江绿城心血管病医院进行治疗的87例轻、中度心功能不全患者进行随机分组探究,对照组44例患者予卡维地洛治疗,研究组43例患者在此基础上联合螺内酯治疗,总疗程为1个月。对比1个月后2组患者的治疗后的临床效果,以探究卡维地洛联合利尿剂对轻、中度心功能不全患者BNP及心功能影响。结果治疗前,对照组与研究组的血清BNP水平无显著差异;治疗后,对照组和研究组的血清BNP水平均比治疗前明显降低（P〈0.05）,且研究组治疗后的血清BNP水平显著低于对照组（P〈0.05）。治疗前,对照组与研究组的心功能的各项指标水平无明显差异。治疗后,对照组和研究组的心率、EF（%）、FS（%）、LVEDD（mm）4项指标均比治疗前明显改善;研究组治疗后的心率和LVEDD（mm）水平显著低于对照组（P〈0.05）,而EF（%）和FS（%）水平高于对照组（P〈0.05）。治疗后,研究组的显效率（73.91%）和总有效率（95.35%）均显著高于对照组的显效率（56.82%）和总有效率（86.36%）（P〈0.05）。治疗后2组患者的身体功能、生活满意度、心理健康、社会适应4项生活质量指标评分均明显高于对照组（P〈0.05）。结论卡维地洛联合利尿剂对轻、中度心功能不全患者BNP及心功能有明显的改善作用,值得临床推广应用。

Objective To explore the influence of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency.Methods87 cases of patients with mild to moderate cardiac insufficiency treated in Zhejiang Greentown Cardiovascular Hospital from June 2014 to June 2016 were divided into the groups randomly.The control group of 44 cases were given carvedilol treatment, and the study group were combined with spironolactone treatment on the basis of the control group, with the total course for a month.Clinical effects were contrasted after a month of treatment in the two groups, in order to explore the influence of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency.ResultsBefore treatment, there was no significant difference in serum BNP level between the control group and the study group.After treatment, serum BNP level significantly decreased when compared with those before treatment in the two groups （P〈 0.05）, which of the study group was significantly lower than that in the control group（P〈 0.05）.Before treatment, there were no significant differences in the levels of cardiac function indexes, and after treatment, heart rate, EF （%）, FS （%）, LVEDD （mm） the four indicators significantly improved when compared with those before treatment, and heart rate, LVEDD （mm） levels were significantly lower than those in the control group（P〈0.05）, and EF （%）, FS （%） levels were significantly higher thatn those in the control group（P〈0.05）.After treatment, the significant effective rate （73.91%） and total effective rate （95.35%） in the study group were significantly higher than that of （56.82%） and（86.36%） in the control group （P〈0.05）.After treatment, body function, life satisfaction, mental health, social adjustment the four parts of quality of life index scores were significantly higher than those in the control group（P〈0.05）.ConclusionIt has obvious improvement effect of carvedilol combined with diuretics on BNP and cardiac function of patients with mild to moderate cardiac insufficiency.It is worthy of clinical application.