螺内酯联合呋塞米治疗老年舒张性心力衰竭的临床疗效

The curative effect of spironolactone combined with furosemide in the treatment of elderly patients with diastolic heart failure

目的探讨螺内酯联合呋塞米治疗老年舒张性心力衰竭的临床疗效。方法选取2013年12月—2015年12月犍为县中医医院收治的100例老年舒张性心力衰竭患者,按随机数字法分为对照组和试验组,每组50例。对照组患者给予呋塞米治疗,试验组患者给予螺内酯联合呋塞米治疗。比较两组患者NYHA分级、左室射血分数(LVEF)、左室舒张末内径(LVEDd)、左室壁节段运动情况〔室壁运动平均收缩期运动速度(Sm)和舒张期早期运动速度(Em)〕、心力衰竭再住院及电解质紊乱情况等。结果治疗前两组患者NYHA分级、LVEF及LVEDd比较,差异无统计学意义(P>0.05);治疗后试验组患者NYHA分级低于对照组,LVEF高于对照组,LVEDd小于对照组,差异有统计学意义(P<0.05)。治疗前两组患者室壁节段运动情况比较,差异无统计学意义(P>0.05);治疗后试验组患者Sm、Em均小于对照组,差异有统计学意义(P<0.05)。两组心力衰竭再住院及由解质紊乱发生率比较,差异无统计学意义(P>0.05)结论螺内酯联合呋塞米治疗老年舒张性心力衰竭的临床疗效显著,可显著改善患者心功能。

Objective To study the curative effect of spironolactone combined with of furosemide in the treatment of elderly patients with diastolic heart failure treatment. Methods In the Traditional Chinese Medicine Hospital of Qianwei County from December 2014 to December 2015,100 elderly patients with diastolic heart failure in elderly were selected,they were randomly divided into control group and experiment group,50 cases in each group. Control group was treated with furosemide treatment,the experimental group were treated with spironolactone combined with furosemide,NYHA classification,left ventricular ejection fraction( LVEF), left ventricular diastolic end diastolic diameter( LVEDd), biventricular movement 〔ventricular wall motion average systolic velocity( Sm),early diastolic velocity( Em) 〕,heart failure caused hospitalization and electrolyte disturbances between the two groups were compared. Results NYHA classification,LVEF,LVEDd between the two groups showed no significant differences before treatment( P > 0. 05),after treatment NYHA classification of the experiment group was lower than the control group,LVEF was higher than the control group,LVEDd was smaller than the control group,the differences were statistically significant( P < 0. 05). Biventricular movement between the two groups showed no significant differences before treatment( P > 0. 05),after treatment Sm,Em of the experimental group were smaller than control group( P < 0. 05). Heart failure caused hospitalization and elecfrolyte disturbances incidence showed no significant diffreences( P > 0. 05). Conclusion Spironolactone combined with furosemide have remarkable effect in the treatment of elderly patients with diastolic heart failure treatment,can significantly improve cardiac function.