螺内酯佐治慢性心力衰竭临床观察

目的观察醛固酮受体拮抗剂螺内酯佐治慢性心力衰竭（chronicheartfailure，CHF）的有效性和安全性。方法将90例CHF随机分为常规治疗组和螺内酯组，每组45例。两组均予常规抗心力衰竭治疗，螺内酯组同时予螺内酯20mg，每日2次口服。治疗时间均为6个月。观察比较两组临床疗效及治疗前后超声心动图、生化指标变化情况。结果治疗后两组心功能均较治疗前改善，但螺内酯组总有效率91．1％，与常规治疗组75．6％比较，差异有统计学意义（P〈0．05）。治疗后螺内酯组血钾水平较治疗前升高，差异有统计学意义（P〈0．05），常规治疗组血钾水平与治疗前比较差异无统计学意义（P〉0．05），两组治疗后血钾水平比较差异有统计学意义（P〈0．05）。螺内酯组治疗后心排出量、左室收缩末期内径、左室舒张末期内径、左室射血分数均优于常规治疗组，差异有统计学意义（P〈0．05）。结论在常规抗心力衰竭治疗基础上使用醛固酮受体拮抗剂螺内酯可改善CHF患者心功能，抑制心室重构，延缓疾病进展。

Clinical Observation of Spironolactane in Treating Chronic Heart Failure

Objective To observe the clinical effects and safety of aldosterone receptors antagonist spironolactone in adjunctive treatment of the chronic heart failure(CHF).Methods 90 patients with chronic heart failure were randomly divided into Spironolactone group(45 cases) and conventional therapy group(45 cases).The two groups were given conventional anti-CHF therapy,the Spironolactone group was given extra 20 mg of Spironolactone twice a day during the same time.6 months after therapy the clinical effect between the two groups,and the biochemical indicator and echocardiography before and after treatment were compared.Results After treatment,the heart function improved in the two groups,and total effectness rate of Spironolactone group was 91.1%.It had statistical significance compared with that of 75.6% of the conventional therapy group(P <0.05).K + was significantly increased after treatment in Spironolactone group compared with that before treatment,and the result showed statistical significance(P <0.05).But there was no significant difference in conventional therapy group before and after treatment,and the result showed no statistical significance(P >0.05).After treatment,K + of the two groups were campared with statistical significance(P <0.05).After treatment,BP,CO,LVEDV,LVESV and LVEF of the patients in the Spironolactone group were significantly improved,with significant difference from that of the conventional therapy group(P <0.05). Conclusion On the basis of conventional anti-CHF threapy,administration of extra Spironolactone is effective and safe,can significantly improve the heart function of patients with CHF,inhibit ventricular remodeling and delay the deterioration of the disease.