Effects of spironolactone on electrical and structural remodeling of atrium in congestive heart failure dogs

Background Renin-angiotensin-aldosterone system has been demonstrated to be associated with both congestive heart failure （CHF） and atrial fibrillation （AF）. This study investigated the effects of spironolactone, a kind of aldosterone antagonist, on atrial electrical remodeling and fibrosis in CHF dogs induced by chronic rapid ventricular pacing. Methods Twenty one dogs were randomly divided into sham-operated group, control group, and spironolactone group. In control group and spironolactone group, dogs were ventricular paced at 220 beats per minute for 6 weeks. Additionally, spironolactone at 15 mg.kgl.d1 was given to dogs 1 week before rapid ventricular pacing until pacing stopped. Transthoracic and transoesophageal echocardiographic examinations were performed to detect structural and functional changes of the atrium. Swan2 Ganz floating catheters were used to measure hemadynamics variances. Atrial effective refractory period （AERP）, AERP dispersion （AERPd） conduction velocity （CV） were determined. The inducib atrial fibrosis was quantified with Masson staining. intra- and inter-atrium conduction time （CT） and intra-atrium ity and duration of AF were also measured in all groups. Finally, Results AERP did not change significantly after dogs were ventricular paced for 6 weeks. However, AERPd, intra- and inter-atrium CT increased significantly, and CV decreased apparently, which was negatively correlated to the atrial fibrosis （r=-0.74, P〈0.05）. Simultaneously, left atriums were enlarged and cardiac hemadynamics worsened in pacing dogs. Although spironolactone could not affect cardiac hemadynamics effectively, it can obviously improve left atrial ejection fraction （P〈0.05）. Spironolactone treatment did not alter AERP duration, but this medicine dramatically decreased AERPd （P〈0.05）, shortened intra- and inter-atrium conduction time （P〈0.05）, and increased atrium CV. Moreover, spironolactone decreased the inducibility and duration of AF （P〈0.05）, as well as at     

螺内酯片有关物质检测方法的优化

目的 优化螺内酯片有关物质的测定方法和供试品溶液制备方法。方法 采用Welch Materials Eclipse XB-C₁₈色谱柱(4.6 mm×250 mm,5μm),以乙腈-水(54∶46)为流动相,流速1.0 mL?min^–1,检测波长254 nm和283 nm,柱温35℃。样品以流动相为提取溶剂,超声提取。结果 主峰与各杂质峰均能良好分离。螺内酯、坎利酮分别在1.00～100.38,1.03～102.53μg?mL^–1内线性关系良好(r均为1.000),回收率分别为99.52%和99.23%。结论 本方法结果准确、重复性好、专属性强,比中国药典方法操作更简便,可为螺内酯片有关物质检测方法的优化提供参考依据。     

螺内酯在维持性血液透析中对患者心血管功能的影响

目的：探讨维持性血液透析中运用螺内酯对患者心血管功能的影响。方法将2013年12月至2015年6月该院血液净化中心80例维持性血液透析患者按随机数字表法分为观察组和对照组,各40例;观察组患者给予螺内酯治疗,对照组给予安慰剂;对比两组患者心血管功能及相关指标变化。结果治疗6个月后,观察组患者心率（HR）、B型脑钠肽（BNP）明显下降,心输出量（CO）、心搏出量（SV）、心搏指数（SI）及心脏指数（CI）明显升高,与对照组比较,差异均有统计学意义（P＜0．05）;而两组心肌耗氧指数（HOI）比较,差异无统计学意义（P＞0．05）。治疗6个月后,观察组患者脉压差（PP）、平均动脉压（MSP）、平均收缩压（MDP）、平均舒张压（MAP）及内皮素‐1（ET‐1）均明显下降,与对照组比较,差异均有统计学意义（P＜0．05）。结论螺内酯有助于改善血液透析患者心血管功能,值得临床运用。     

复方螺内酯霜的HPLC测定

采用高效液相色谱法测定复方螺内酯霜中螺内酯的含量。色谱条件μBondapakC18色谱柱(3.9×300mm);磷酸盐缓冲液(0.025mol/L,pH6.5)-甲醇(40∶60)为流动相;醋酸氢化可的松为内标;检测波长240nm;柱温40℃。在1～10mg/L范围内线性关系良好(r=0.9999);方法平均回收率为99.8%(RSD=1.16%)。     

外源性醛固酮调控大鼠心肌钙调神经磷酸酶的研究

目的　研究外源性醛固酮诱导的心肌内肥大信号分子———钙调神经磷酸酶(CaN)活性和分布变化及其调控机制。方法　取雄性Wistar大白鼠 2 1只 ,随机分为 3组 ,醛固酮 (Ald)组 (以Ald 1 8μg/d腹腔内注射 4周 )、螺内酯组 (以Ald处理同时予螺内酯2 0mg·kg-1 ·d-1 灌胃 4周)及正常对照组。以放免法测血Ald、血管紧张素Ⅱ(AngⅡ)和内皮素 (ET)浓度 ;以硝酸盐法测定血NO浓度 ;以改良底物发色法测得心肌组织CaN活性 ;以免疫组化法观察CaNAβ抗原在心肌细胞内的分布。结果　Ald组大鼠血Ald浓度较对照组上升了 1 6 2倍 ;血NO-3 浓度明显下降 ;而Ald /NO-3 上升了 2 95倍 ,心肌组织CaN活性升高了 1 4 7倍 ;CaNAβ抗原分布于细胞浆 ,在近胞膜处及细胞核周CaNAβ染色加深。螺内酯干预使血AngⅡ浓度下降、NO-3 浓度明显升高 ;Ald/NO-3 、ET/NO-3 、AngⅡ/NO-3 和心肌组织CaN活性均明显下降 ;近胞膜处及细胞核周CaNAβ染色减轻。结论　醛固酮可能是内皮活性物质稳态失衡及心肌细胞内信号分子 CaN激活的重要刺激因子。目的　研究外源性醛固酮诱导的心肌内肥大信号分子———钙调神经磷酸酶(CaN)活性和分布变化及其调控机制。方法　取雄性Wistar大白鼠 2 1只 ,随机分为 3组 ,醛固酮 (Ald)组 (以Ald 1 8μg/d腹腔内     

A case series of 20 women with hidradenitis suppurativa treated with spironolactone

Hidradenitis suppurativa (HS) is an uncommon chronic skin condition that can range in severity from a single nodule to extensive disease and can have a profound effect on quality of life. Anti‐androgen medication has been suggested as a possible management strategy in female patients with HS and is mentioned in review articles as a treatment option. Despite this, there is limited literature documenting the use of anti‐androgens in HS. We present our experience with 20 patients with HS treated with oral spironolactone. We advocate spironolactone as a useful, low‐cost first‐line treatment for women with HS, with relatively few side‐effects.     

比索洛尔、依那普利和螺内酯联合治疗风湿性心脏病慢性心力衰竭的效果

目的:观察比索洛尔、依那普利和螺内酯联合治疗风湿性心脏病（风心病）慢性心力衰竭（心衰,CHF）对心脏重构的影响。方法: 风心病并发心衰患者86例,随机分为比索洛尔、依那普利和螺内酯联合治疗组（试药组）以及常规治疗方案对照组（对照组）。在治疗后1年测定心功能与左室内径等指标。结果: 试药组左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）显著下降,左室射血分数（LVEF）增加显著,与对照组比较有显著差异（均P<0．05）。结论: 比索洛尔、依那普利和螺内酯联合治疗治疗风心病心力衰竭较常规治疗方法在改善心衰,阻止心脏重构方面效果更好。