洛汀新联合螺内酯对原发性高血压合并心力衰竭患者心功能及BNP、CRP的影响

摘要

Objective To observe the influence of lotensin combining spironolactone on heart function, brain natriuretic peptide (BNP) and C-reactive protein (CRP) in patients with essential hypertensive (EH) complicated by heart failure.Methods The patients (n=97, male 52, female 45, aged from 50 to 74 and average age=62.12±10.94) were chosen from the Tongren Hospital of Shanghai City from Feb. 2015 to Jul. 2015. All patients were randomly divided into combining group (n=49) and lotensin group (n=48). The combining group was treated with lotensin combining spironolactone and lotensin group, with lotensin for 1 y. The changes of left ventricular end-diastolic inner diameter (LVEDd), left ventricular ejection fraction (LVEF), BNP and CRP were detected before and after treatment, and curative effects were reviewed after treatment in 2 groups.Results After treatment for 1 y, BNP, CRP, LVEDd and LVEF were meliorated in 2 groups (allP<0.05). Compared with lotensin group after treatment for 1 y, BNP [(946.28±329.14) ng/mLvs. (349.17±123.96) ng/mL], CRP [(6.38±2.17) μg/mLvs. (3.41±2.10)μg/mL], LVEDd [(60.12±4.22) mmvs. (56.21±3.27) mm] and LVEF [(38.27±3.19)%vs. (43.21±3.08)%] were meliorated more significantly in combining group (allP<0.05). The total effective rate was 97.96% in combining group, which was significantly higher than that in lotensin group (81.25%,P<0.05).Conclusion The therapy of lotensin combining spironolactone can meliorate BNP, CRP and heart function in patients with EH complicated by heart failure, and it is worthy of clinic application.%目的 观察洛汀新联合螺内酯对原发性高血压合并心力衰竭患者心功能及脑钠肽(BNP)、C反应蛋白(CRP)的影响.方法 选择2015年2月~7月于上海市同仁医院就诊的原发性高血压合并心力衰竭患者97例,其中男性52例,女性45例,年龄50~74岁,平均年龄(62.12±10.94)岁.根据入院顺序随机将患者分为联合组(49例)及单药组(48例).联合组给予洛汀新联合螺内酯治疗,单药组仅给予洛汀新治疗,治疗周期为1年.治疗前后检测两组患者左室舒张末内径(LVEDD)、左室射血分数(LVEF)、BNP和CRP情况.治疗后评价两组疗效.结果 治疗1年后,两组BNP、CRP、LVEDD以及LVEF均较治疗前明显改善,差异有统计学意义(P均<0.05).与单药组治疗1年后比较,联合组BNP、CRP、LVEDD以及LVEF均改善更明显,[(946.28±329.14)ng/mlvs.(349.17±123.96)ng/ml]、[(6.38±2.17)μg/mlvs.(3.41±2.10)μg/ml]、[(60.12±4.22)mmvs.(56.21±3.27)mm]、[(38.27±3.19)%vs.(43.21±3.08)%],差异均有统计学意义(P均<0.05).联合组治疗总有效率为97.96%,明显高于单药组的81.25%,差异具有统计学意义(P<0.05).结论 洛汀新联合螺内酯治疗可改善原发性高血压合并心力衰竭患者BNP、CRP水平以及心功能状况,值得临床推广应用.