小剂量醛固酮拮抗剂治疗慢性充血性心力衰竭的临床疗效观察

目的观察小剂量安体舒通治疗CHF的疗效及安全性。方法选择109例无休克及严重肝肾功能不全及高血钾的CHF患者为对象，将所有病人随机分成治疗组56例、对照组53例．对照组应用常规强心、利尿、ACEI或ARB等基础治疗．治疗组在基础治疗的同时，给予安体舒通20mg／d，24周为1疗程。服药前及服药24周后分别测定心电图（ECG）、动态心电图（Holter）、超声心动图及血生化指标，观察治疗效果、不良反应：结果CHF治疗的总有效率．2组间无统计学意义（P〉0．05），但按心功能分组研究发现，NYHA分级心功能Ⅳ级的2组间疗效比较，治疗组高于对照组（P〈0．05）、治疗组治疗后的室性心律失常明显减少（P〈0．05），左室舒张末内径减少（P〈0．05），左室射血分数增加（P〈0．05），低钾及低镁血症得到纠正．对血生化无不良影响，无严重的不良反应发生．结论小剂量安体舒通治疗CHF安全有效。

Clinical Observation of Treatment for Congestive Heart Failure with Low-dose Antisterone

OBJECTIVE to study the curative effect and safety of ow-dose Antisterone for congestive heart failure (CHF) .METHODS 109 CHF patients without shock, serious hepatic and renal insufficiency and hyperkalemia, were randomly divided into comparison group (53cases) who were given Antisterone 20 mg/d, besides routine methods.The course of treatment lasted 24 weeks.It was observed before the patients took the drugs and 24 weeks later that the curative and side effect, the change of electrocardiograms (ECG), echocardiography and biochemical criterion ecl.RESULTS There was no statistically significancy bewtween the 2 groups at the total effective rate of the CHF treatment (P>0.05) , but we found that the effective rate of the treatment group in the serious patients significantly increased (P<0.05) .The ventricular premature of the treatment group obviously decreased (P<0.05) , hypokalemia and hypomagnesemia had been corrected, and we did not find adverse change in biochemical criterion or serious side effect.CONCLUSION Low-dose Antisterone to treat the CHF patients would be safe and effective.