螺内酯治疗严重心力衰竭临床疗效观察

目的探讨螺内酯对严重心力衰竭（简称心衰）的临床疗效。方法对98例严重心衰患者随机分组，对照组接受常规抗心衰治疗，治疗组常规抗心衰治疗加用螺内酯10-20mg／d，服用1年。监测临床症状、体征及血清钾、肌酐、尿素氮，超声心动图测定左室射血分数（LVEF）、E／A比值、Holter监测室性心律失常的发生率。结果治疗组较对照组血清钾有所升高（P〈0．05），而血肌酐、尿素氮水平无明显变化；Holter结果显示治疗组24h室性早搏发生频率及24h非持续性室性心动过速发生率均明显减少P均〈0．01；超声心动图测定2组LVEF、E／A比值均有改善，治疗组较对照组改善明显（P〈0．05），治疗组总有效率显著高于对照组（P〈0．05）。结论常规抗心衰治疗加用螺内酯10-20mg／d治疗心衰，疗效肯定，副作用小，较为安全。

Clinical observation of severe congestive heart failure treated by Spironolactone

Objective Discuss the effect of grave cardiac failure treated by spironolactone.Method 98 cases of patients with heart failure were randomly divided into two groups, control group accepting routine resisting the heart failure treatment, the routine heart curing group resisting declines treatment add with spironolactone 10~20 mg/ds, carrying out 1 year together.Monitor clinical symptoms, body presentation and serum potassium, muscle anhydride, urea nitrogen, surpass sound being touched pursuing the admeasurement LVEF, E/A ratio on blood, Hoher monitored arrhythmia cordis occurrence rate.Results The potassium curing a group contrasting group serum comparatively elevates （P〈0.05）, but blood muscle anhydride, obvious change of urea nitrogen level nothing; （P〈0.01） Hoher result was demonstrated curing early plentiful ：24 set of ventricular arrhythmias （P〈0.01）and 24 h height persistence heart-hurry occurrence rate to fall off obviously equally;Surpass sound being touched pursuing admeasurement two group LVEF, that E/A ratio has improvement to cure a group equally is improve noticeably（P〈0.05 ）, cures always efficient notable group of group higher than collation（P〈0.05 ）.Conclusion Routine Heart failure was treated by spironolactone 10-20 mg/d ,whose curative effect was affirmative,the side effect was acceptable,it was safe.