螺内酯联合氢氯噻嗪治疗老年慢性心力衰竭的临床效果及其对患者生活质量的影响

Clinical effect of spironolactone combined with hydrochlorothiazide in the treatment of chronic heart failure in the elderly and its influence on quality of life

目的探讨螺内酯联合氢氯噻嗪治疗老年慢性心力衰竭(CHF)的临床效果及其对患者生活质量的影响。方法将2016年1月至2018年1月医院收治的128例老年CHF患者均分为两组,对照组给予常规治疗,试验组在此基础上采用螺内酯联合氢氯噻嗪。比较两组治疗前、后LVEF、和肽素、NT-proBNP、6 min步行距离、生活质量及SPBS评分;记录不良反应发生率。结果试验组临床总有效率明显高于对照组(P<0.05)。治疗后,两组LVEF增加,和肽素、NT-proBNP减少,6 min步行距离延长,生活质量和SPBS评分明显下降,且试验组上述指标均明显优于对照组(P<0.05)。但两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论螺内酯联合氢氯噻嗪可显著改善老年CHF患者心功能,增强其运动耐受力,改善其精神状况,疗效确切且安全性好。

Objective To investigate the clinical effect of spironolactone combined with hydrochlorothiazide in the treatment of chronic heart failure (CHF) in the elderly and its effect on quality of life.Methods A total of 128 elderly patients with CHF admitted to our hospital from January 2016 to January 2018 were divided into two groups.The control group was given conventional treatment.The experimental group was given spironolactone combined with hydrochlorothiazide on the basis of the confrol group.The LVEF, copeptin, NT-proBNP, 6 min walking distance, the scores of quality of life and SPBS before and after treatment were evaluated;the incidence of adverse reactions was recorded.Results The total clinical effective rate of the experimental group was significantly higher than that of the control group (P<0.05).After treatment, the LVEF increased, the copetin and NT-proBNP decreased, the walking distance of 6 min was prolonged, the scores of quality of life and SPBS decreased significantly in the two groups, and the above indexes of the experimental group were significantly better than the control group (P<0.05).However, there was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Conclusion Spironolactone combined with hydrochlorothiazide can significantly improve cardiac function, enhance exercise tolerance and improve mental status in elderly patients with CHF, which has good curative effect and safety.