螺内酯治疗老年高血压舒张性心力衰竭的疗效

目的：观察螺内酯对老年高血压舒张性心力衰竭(DHF)的临床疗效与机制。方法：入选老年高血压伴有DHF病人78例,随机分入螺内酯组(n=40)和对照组(n=38)。对照组采用常规治疗,螺内酯组加用螺内酯平均剂量47 mg·d~(-1),疗程6mo。在治疗前后检测血清Ⅲ型前胶原氨基端肽(PⅢNP)、脑钠肽(BNP)、6min步行试验及心脏超声。结果：治疗后螺内酯组6-min步行距离(559±s 62)m,较治疗前(318±41)m改善；与对照组(442±57)m比较有非常显著差异(P＜0．01)。2组治疗后左心室舒张功能超声指标优于治疗前,并优于对照组(P＜0．01)。结论：螺内酯治疗老年高血压DHF病人可改善心脏舒张功能,提高活动耐量。

Effects of spironolactone in treatment of elderly hypertensive patients with diastolic heart failure

AIM:To evaluate the clinical effect of spironolactone on diastolic heart failure in elderly hy- pertensive patients.METHODS:Seventy-eight elderly hypertensive patients with diastolic heart failure were randomized into two groups,treated group(n=40,treated with spironolactone 47 mg·d~(-1)and common drugs) and control group(n=38,treated with eommon drugs).The concentration of aminoterminal propeptide of typeⅢprocollagen(PⅢP)and brain natriuretic peptide(BNP)were measured before and after 6 mo of treatments. Doppler ultrasound recordings and 6-min walk test were obtained from all patients to determine the left ventricu- lar diastolic function.RESULTS:Within 6-min walk test,the patients of treated group could walk longer dis- tance(559±62)m than before(318±41)m and control group(442±57)m,P＜0.01.All left ventrieu- lar diastolic function data of treated group were better than those in control group(P＜0.01).CONCLUSION: The spironolactone could improve the heart diastolic function and exercise tolerance in elderly hypertensive pa- tients with diastolic heart failure.