目的 探讨实时三维超声心动图( real time 3-dimensional echocardiography , RT-3DE)对螺内酯治疗高血压性心脏病的效果评价. 方法 以笔者医院2011年1月~2012年1月间收治的高血压性心脏病患者104例为研究对象,随机分为对照组和观察组,所有患者均行常规治疗,观察组在此基础上口服螺内酯,比较两组患者心室形态学指标和功能学指标之间的差异. 并探讨RT-3DE评价心室重构程度指标LVRI( left ventricular remodeling index )与胱抑素C( cystatin C, CysC)之间的相关性. 结果 观察组患者左心室舒张末期容积(left ventricular end-diastolic volume, LVEDV)、左心室收缩末期容积(left ventricular end systolic volume, LVESV)和左心室射血分数(left ventricular ejection fraction, LVEF)等心室形态和功能学指标较对照组有改善(P<0.05),CysC和LVRI都显示观察组患者心室重构程度更低(P<0.05),无论在观察组还是在对照组中,CysC和LVRI都具有良好相关性( r观察组 =0.913,r对照组 =0.856,P<0.05). 结论 螺内酯对于高血压性心脏病患者的心室重构有积极作用,RT-3DE能够从心室形态学和功能上双重评价对患者心室重构程度的影响.%Objective To investigate the effect evaluation of spironolactone in the treatment of hypertensive heart disease by the real time 3-dimensional echocardiography .Methods Totally 104 patients with hypertensive heart disease were in the study from Jan 2011 to Jan 2012 of our department and divided into objective group and control group .Conventional treatments were put in all the patients and the spironolactone was used in objective group patients only .The results of ventricular morphology and function indexes were compared be -tween the two groups, and then investigate the relationship between cystatin C (CycC) and left ventricular remodeling index (LVRI) at the same time.Results There were significant differences in the comparison of ventricular morphology and function indexes .The left ventric-ular end-diastolic volume(LVEDV), left ventricular end systolic volume (LVESV) and left ventricular ejection fraction (LVEF) of ob-jective group were more advantageous than flowse of control group for prognosis .The same results were observed in the comparison of Cys C and LVRI.Moreover, Cyc C and LVRI had certain correlation in the study .Conclusion The spironolactone can play a positive role in the treatment for the patients with hypertensive heart disease .In the meantime, the RT-3DE is a good evaluation method for the develop-ment of ventricular morphology and function .
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