螺内酯在维持性血液透析中对患者心血管功能的影响

摘要

目的：探讨维持性血液透析中运用螺内酯对患者心血管功能的影响。方法将2013年12月至2015年6月该院血液净化中心80例维持性血液透析患者按随机数字表法分为观察组和对照组，各40例；观察组患者给予螺内酯治疗，对照组给予安慰剂；对比两组患者心血管功能及相关指标变化。结果治疗6个月后，观察组患者心率（HR）、B型脑钠肽（BNP）明显下降，心输出量（CO）、心搏出量（SV）、心搏指数（SI）及心脏指数（CI）明显升高，与对照组比较，差异均有统计学意义（P＜0．05）；而两组心肌耗氧指数（HOI）比较，差异无统计学意义（P＞0．05）。治疗6个月后，观察组患者脉压差（PP）、平均动脉压（MSP）、平均收缩压（MDP）、平均舒张压（MAP）及内皮素‐1（ET‐1）均明显下降，与对照组比较，差异均有统计学意义（P＜0．05）。结论螺内酯有助于改善血液透析患者心血管功能，值得临床运用。%Objective To explore the effects of spironolactone on cardiovascular function in patients undergoing maintenance hemodialysis .Methods According to the random number table ,80 cases of patients undergoing maintenance hemodialysis in blood purification center of our hospital from December 2013 to June 2015 were randomly divided into the observation group and control group ,40 cases in each group .In the observation group ,patients were treated with spironolactone therapy ,while patients in the con‐trol group took a placebo .The cardiovascular function and related indexes were compared between the two groups .Results After 6 months of treatment ,the HR and BNP were decreased ,and CO ,SV ,SI and CI were increased in the observation group ,statistically significant differences were found in these indexes when compared with the control group (P<0 .05);there was no statistically sig‐nificant difference in HOI between the two groups(P>0 .05) .The PP ,MSP ,MDP ,MAP and ET‐1 in the observation group were significantly decreased after 6 months of treatment ,which were statistically different with those in the control group (P<0 .05) . Conclusion Spironolactone contributes to improving cardiovascular function of patients undergoing maintenance hemodialysis ,it is worthy of clinical application .