厄贝沙坦联合螺内酯在慢性心力衰竭中的应用效果

Effect of irbesartan combined with spironolactone in the treatment of chronic heart failure

目的研究厄贝沙坦联合螺内酯在慢性心力衰竭中的应用效果及对病人心功能的影响。方法选择慢性心力衰竭病人60例,按随机数字表法均分为观察组、对照组。对照组采用常规治疗,观察组加用厄贝沙坦联合螺内酯治疗。观察两组临床疗效,心功能指标,血压、心率,血清B型脑钠肽(BNP)及高敏C-反应蛋白(hs-CRP)水平。结果治疗后,观察组(86.67%)总有效率与对照组(63.33%)比较,差异有统计学意义(P<0.05);两组病人心功能指标较治疗前改善,但观察组改善更明显,左室舒张末期内径(LVDd)[(52.33±4.92)mm vs(59.46±5.57)mm]、左室收缩末期内径(LVSd)[(40.24±4.13)mm vs(46.95±4.87)mm]、左室射血分数(LVEF)[(48.62%±7.13%)vs(42.41%±6.65%)],差异有统计学意义(P<0.05);两组病人血压、心率较治疗前下降,但观察组下降更明显[舒张压(75.36±3.54)mm Hg vs(85.47±4.09)mm Hg,收缩压(130.65±8.74)mm Hg vs(139.22±9.35)mm Hg,心率(76.72±10.56)次/分钟vs(82.59±11.34)次/分钟],差异有统计学意义(P<0.05);两组BNP、hs-CRP水平较治疗前下降,但观察组下降更明显[BNP(1.71±0.34)μg·L^(-1)vs(2.48±0.57)μg·L^(-1),hs-CRP(6.26±1.03)μg·L^(-1)vs(8.79±1.12)μg·L^(-1)],差异有统计学意义(P<0.05)。结论厄贝沙坦与螺内酯联合治疗慢性心力衰竭应用疗效确切,能有效改善病人心功能,延缓病情的发展。

Objective To discuss the effect of irbesartan combined with spironolactone in the treatment of chronic heart failure.Methods 60 cases of patients with chronic heart failure were choosen in our hospital.They were divided into the control group and the observation group by stochastic method,30 cases in each group.The control group were treated with the conventional therapy.The observation group under the conventional therapy,add irbesartan combine spironolactone for treatment.The clinical curative effect,heart function index,blood pressure,heart rate,serum BNP and hs-CRP level of the two groups patients were observed.Results After the treatment,the total effective rate of the observation group was 86.67% （28/30） compared with the control group 63.33%（19/30）,and the difference was statistically significant （P〈0.05）.Compared with before treatment,cardiac function was improved in the two groups,however the improvement in the observation group was more obvious LVDd [（52.33±4.92） mm vs （59.46±5.57） mm],LVSd[（40.24±4.13） mm vs （46.95±4.87） mm],LVEF[（48.62%±7.13%） vs （42.41%±6.65%）].The difference was statisti-cally significant （P〈0.05）.Blood pressure and heart rate were decreased in the two groups before treatment,while the observation group decreased more significantly[diastolic pressure：（75.36±3.54） mmHg vs （85.47±4.09） mmHg,systolic pressure：（130.65±8.74） mmHg vs （139.22±9.35） mmHg,heart rate：（76.72±10.56）times/min vs （82.59±11.34） times/min],the difference was statistically significant （P〈0.05.The levels of BNP and hs-CRP in the two groups were lower than before treatment,while the observation group decreased more significantly [BNP（1.71±0.34） μg·L-1 vs （2.48±0.57） μg·L-1,hs-CRP（6.26±1.03） μg·L-1 vs （8.79±1.12） μg·L-1],the difference was statistically significant （P〈0.05）.Conclusion Irbesartan combined with spironolactone to treat chronic heart failure is reliable and can effectively improve the patient＇s heart function and delay the development of the disease.