贝那普利联合螺内酯治疗非腺瘤型PA患者的疗效

The efficacy of benazepril combined with spironolactone in the treatment of patients with non-adenomatous PA

目的探讨贝那普利联合螺内酯治疗非腺瘤型原发性醛固酮增多症(PA)的效果及其对血压水平、血清钾浓度及心功能的影响。方法选取我院收治的非腺瘤型PA患者107例,按随机数字表法分为对照组和观察组,对照组53例给予硝苯地平片联合螺内酯治疗,观察组54例给予贝那普利联合螺内酯治疗。对比两组的临床疗效、血压水平、生化指标、心功能、不良反应。结果观察组的临床疗效优于对照组(P<0.05);收缩压与舒张压均低于对照组(P<0.05);观察组治疗后的血清钾、血肌酐、醛固酮肾素比值(ARR)、坐位醛固酮低于对照组,坐位肾素高于对照组(P<0.05);观察组治疗后的左心室射血分数(LVEF)高于对照组,左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)小于对照组,6 min步行距离长于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论贝那普利联合螺内酯可通过改善非腺瘤型PA患者的血压与生化指标,改善患者的心功能,以提高治疗效果,且不良反应少。

Objective To investigate the effect of benazepril combined with spironolactone in the treatment of pa⁃tients with non-adenomatous primary aldosteronism(PA)and its effect on blood pressure,serum potassium concentration and cardiac function.Methods 107 patients with non-adenomatous PA were selected and randomly divided into the con⁃trol group and the observation group.53 cases in the control group were given nifedipine tablets combined with spironolac⁃tone,54 cases in the observation group were treated with benazepril combined with spironolactone.The clinical efficacy,blood pressure level,biochemical indicators,cardiac function and adverse reactions of the two groups were compared.Re⁃sults The clinical efficacy of the observation group was better than that of the control group(P<0.05).The systolic and di⁃astolic blood pressure in the observation group were lower than those of the control group(P<0.05).The observation group's serum potassium,blood creatinine,aldosterone-renin ratio(ARR)and site-aldosterone after treatment were lower than those in the control group,sitting renin was higher than that in the control group(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)of the observation group was higher than the control group;left ventricular end systol⁃ic diameter(LVESD)and left ventricular end diastolic dimension(LVEDD)were less than the control group,and the 6-min walking distance was longer than the control group(P<0.05).The incidence of adverse reactions in the observation group was lower than that of the control group(P<0.05).Conclusion Benazepril combined with spironolactone can im⁃prove the blood pressure and biochemical indexes of patients with non-adenomatous PA,improve the patient's heart func⁃tion to improve the efficacy and cause fewer adverse reactions.