螺内酯对慢性心力衰竭患者心脏自主神经功能的影响

目的：观察螺内酯对慢性心力衰竭（CHF）患者心脏自主神经功能的影响。方法：回顾性收集某院2012年12月-2014年12月收治的CHF患者52例，按照给药方案的不同分为观察组和对照组。对照组26例采取基础抗心衰方案治疗；观察组26例在基础抗心衰治疗上加用螺内酯（20 mg·d^-1），治疗前1天及治疗后16周行动态超声心动图检查，通过系统分析得出心率变异性（HRV）的时域及频域分析指标。结果：与对照组比较，螺内酯治疗16周后HRV明显改善（t=13.406，P<0.05）；时域指标：全部窦性R-R间期的标准差（SDNN）、全部窦性R-R间期差值的均方根（rMSSD）、每5分钟窦性R-R平均值的标准差（SDANN）、SDNN的均值（SDNNI）均明显升高（t=5.829，10.256，6.005，7.128，P<0.05）；频域指标：低频（LF）、高频（HF）也明显提高（t=9.231，7.441，P<0.05）。结论：螺内酯可明显改善CHF患者的HRV，改善心脏自主神经功能。

Effects of spironolactone on functions of cardiac autonomic nerves in patients with chronic heart failure

OBJECTIVE To observe effects of spironolactone on cardiac autonomic nervous function in patients with chronic heart failure (CHF).METHODS Fifty two CHF patients were selected in our hospital from May 2012 to April 2014. Twenty six patients in control group received basic regimen against heart failure, and 26 patients in observation group took spironolactone (20 mg·d^-1) based on basic regimen. By using dynamic echocardiography, time domain and frequency domain analysis indicators of heart rate variability (HRV) were obtained through systematic analysis 1 day before and 16 weeks after treatment.RESULTS After 16 weeks of treatment with spironolactone, HRV was significantly improved compared with control group, time domain indicators, mean values of SDNN, rMSSD, SDANN and SDNNI were significantly higher (t=13.406, 5.829, 10.256, 6.005, 7.128, all P<0.05). Frequency domain parameters, low frequency (LF) and high frequency (HF) were also improved significantly (t=9.231, 7.441, all P<0.05).CONCLUSION Spironolactone can significantly improve HRV in patients with CHF, and improving cardiac autonomic nervous function.