螺内酯在射血分数中间值心衰的应用价值研究

Study on the Application Value of Spironolactone in Heart Failure with Mid-range Ejection Fraction

目的:探讨醛固酮受体拮抗剂(ARA)螺内酯在射血分数中间值心衰(HFmrEF)治疗中的应用价值。方法:选取2017年1月-2018年12月在笔者所在医院诊断为HFmrEF的116例患者作为研究对象。按照随机数字表法将116例HFmrEF患者分为试验组(n=56)和对照组(n=60)。对照组给予常规抗心衰药物治疗,试验组在此基础上加用螺内酯治疗。比较两组治疗前后NT-proBNP、6 min步行距离(6MWD)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、左室射血分数(LVEF)水平及主要心脏不良事件(MACE)发生率。结果:试验组治疗后NT-proBNP、6MWT、LVDd、LVDs、LVEF均明显优于对照组,MACE发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论:螺内酯能改善HFmrEF患者心功能,降低心血管风险,值得临床进一步推广。

Objective:To investigate the application value of aldosterone receptor antagonist (ARA) Spironolactone in the treatment of heart failure with mid-range ejection fraction (HFmrEF).Method:A total of 116 patients diagnosed with HFmrEF in our hospital from January 2017 to December 2018 were selected as study subjects.According to the random number table method,116 HFmrEF patients were divided into the experimental group (n=56) and the control group (n=60).The control group received routine anti-heart failure drug treatment,while the experimental group was treated with Spironolactone on this basis.The level of NT-proBNP,6-min walking distance (6MWD),left ventricular end-diastolic diameter (LVDd),left ventricular end-systolic diameter (LVDs),left ventricular ejection fraction (LVEF),and the incidence of major adverse cardiac events (MACE) of two groups were compared.Result:After treatment,NT-proBNP,6MWD,LVDd,LVDs and LVEF in the experimental group were all significantly better than those in the control group,and the incidence of MACE was significantly lower than that in the control group,the differences were statistically significant (P<0.05).Conclusion:Spironolactone can improve cardiac function and reduce cardiovascular risk in HFmrEF patients.It is worthy of further clinical promotion.