螺内酯联合曲美他嗪治疗慢性心力衰竭的疗效分析

Efficacy of Spironolactone Combined with Trimetazidine in the Treatment of Chronic Heart Failure

目的探讨螺内酯联合曲美他治疗善慢性心力衰竭患者的远期预后疗效及其改善患者心功能的作用。方法选取2016年2月~2016年8月我院收治的CHF患者86例为研究对象,随机分为观察组和对照组,各43例,对照组予常规抗心衰治疗,观察组在常规抗心衰治疗基础上加用螺内酯20 mg/d联合曲美他嗪20 mg tid服12个月,观察治疗前后两组患者左室射血分数(LVEF)、6 min步行试验(6MWD)、NYHA心功能分级、左室结构功能指标及BNP变化水平。结果治疗后NYHA心功能分级比较观察组优于对照组,差异有统计学意义(P<0.05);治疗后观察组LVEF、6MWD较对照组有明显升高,BNP较对照组下降明显,差异有统计学意义(P<0.05);治疗后观察组LVESD及LVEDD较对照组有明显缩短,LVESV较对照组有明显降低,差异均有统计学意义(P<0.05)。结论对慢性心力衰竭患者加用螺内酯联合曲美他嗪治疗,能够改善患者临床症状和心功能,同时改善患者左室结构和功能及远期预后,值得推广。

Objective To investigate the long-term prognosis of spironolactone combined with trimetazol in the treatment of chronic heart failure(CHF)and the effect of improving cardiac function.Methods From February 2016 to August 2016,86 patients with CHF were randomly divided into two groups:observation group(n=43)and control group(n=43).The control group was treated with routine anti-heart failure therapy,the observation group was treated with spironolactone 20 mg/d combined with trimetazidine 20 mg tid for 12 months.The left ventricular ejection fraction(LVEF)and left ventricular ejection fraction(LVEF)of 6 min walking test were measured before and after treatment as well as the index of left ventricular structure and function and the level of BNP.Results After treatment,the NYHA cardiac function grading in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the LVEF and 6MWD levels in the observation group were significantly higher than those in the control group,and BNP was significantly lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,the LVESD and LVEDD in the observation group were significantly shorter than those in the control group,and the LVESV was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion The addition of spironolactone combined with trimetazidine to patients with chronic heart failure can improve clinical symptoms and heart function,improve left ventricular structure and function,and improve long-term prognosis.It is worth promoting.