厄贝沙坦联合螺内酯在慢性心衰中的应用效果及对患者心功能的影响

Application effect of irbesartan combined with spironolactone on chronic heart failure and its effect on cardiac function

目的研究厄贝沙坦联合螺内酯在慢性心衰中的应用效果及对患者心功能的影响。方法选择2015年2月~2016年2月天津市海河医院收治的慢性心衰患者60例,按随机法分为观察组和对照组,各30例。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2组临床疗效、心功能指标,血压、心率、血清BNP及hs-CRP水平。结果治疗后,观察组总有效率86.67%与对照组63.33%比较差异具有统计学意义（P〈0.05）;2组患者心功能指标较治疗前改善,但观察组改善更明显[LVDd（52.33±4.92）mm比（59.46±5.57）mm,LVSd（40.24±4.13）mm比（46.95±4.87）mm,LVEF（48.62±7.13）%比（42.41±6.65）%],差异具有统计学意义（P〈0.05）;2组患者血压、心率较治疗前下降,但观察组下降更明显（舒张压[（75.36±3.54）mmHg比（85.47±4.09）mmHg],收缩压（130.65±8.74）mmHg比（139.22±9.35）mmHg,心率（76.72±10.56）次/min比（82.59±11.34）次/min],差异具有统计学意义（P〈0.05）;2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）ng/mL比（2.48±0.57）ng/mL,hs-CRP（6.26±1.03）μg/mL比（8.79±1.12）μg/mL],差异具有统计学意义（P〈0.05）。结论厄贝沙坦与螺内酯联合治疗慢性心衰应用疗效确切,能有效改善患者心功能,延缓病情的发展。

Objective To study the effect of irbesartan combined with spironolactone on chronic heart failure and its effect on cardiac function.Methods 60 cases of patients with chronic heart failure treated in our hospital from February 2015 to February 2016 were randomly divided into the control group and the observation group,30 cases in each group. The control group was treated with conventional therapy,the observation group was treated with irbesartan and spironolactone. The clinical efficacy,cardiac function indexes,blood pressure,heart rate,serum BNP and hs-CRP levels were observed in the 2 groups. Results After treatment,the total effective rate of the observation group was 86. 67%（ 28/30） compared with the control group63. 33%（ 19/30）,and the difference was statistically significant（ P 〈0. 05）; cardiac function was improved in the two groups compared with before treatment,but 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 statistically significant（ P 〈0. 05）; Blood pressure and heart rate were decreased in the two groups before treatment,but 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,but the observation group decreased more significantly[BNP（ 1. 71 ± 0. 34） ng/mL vs（ 2. 48 ± 0. 57） ng/mL,hs-CRP（ 6. 26 ± 1. 03） μg/mL vs（ 8. 79 ± 1. 12） μg/mL,the difference was statistically significant（ P 〈0. 05）. Conclusion Irbesartan combine spironolactone treat with chronic heart failure have reliable curative effect,and it can effectively improve the patient＇s heart function,delay the development of the disease.