卡维地洛联合螺内酯对慢性心力衰竭患者心功能的影响

摘要

Objective To study the effect of carvedilol combined with spironolactone on cardiac function of patients with chronic heart failure.Methods Two hundred patients with chronic heart failure were included.All patients were randomized into observation group and control group.Patients in observation group were given carvedilol combined with spironolactone therapy,while patients in control group were given carvedilol therapy.Follow-up was conducted for 6 months,and the cardiac function,brain natriuretic peptide (BNP) and glutathioneperoxidase(GSH-PX)were compared.Results The total effective rate in observation group was 93.0%,which was higher than 84.0% in control group (P <0.01).The LVEF,LVEDD and BNP after treatment in both groups were significantly lower than those before treatment,while the LVESD and GSH-PX after treatment in both groups were significantly higher than those before treatment (P <0.05).Conclusions Carvedilol combined with spironolactone therapy in patients with CHF can improve cardiac func-tion,inhibit myocardial remodeling,and reduce heart failure indicators.%目的：探讨卡维地洛联合螺内酯对慢性心力衰竭（Chronic heart failure，CHF）患者心功能的影响。方法选择200例诊断为 CHF 的患者作为研究对象，采用随机数字表法分为观察组与对照组，均给予常规吸氧、硝酸酯类、正性肌力药物等治疗，观察组同时给予给予卡维地洛联合螺内酯治疗，对照组同时给予单独卡维地洛治疗。随访观察6月，比较两组患者心脏功能、血浆脑钠肽（Brain Natriuretic Peptide，BNP）及谷胱甘肽过氧化物酶（Glutathioneperoxidase，GSH-PX）的差异。结果观察组总有效率93．0％，明显高于对照组84．0％（P ＜0．01）。治疗后两组左室射血分数（LVEF）、左室收缩期末内径（LVESD）及 BNP均较治疗前降低，而 LVESD 及 GSH-PX 较治疗前升高（P ＜0．05）；观察组较对照组改善更明显，差异有统计学意义（P ＜0．05）。结论卡维地洛联合螺内酯治疗 CHF 可以更好改善患者心功能，抑制心肌重塑，降低心衰指标。