培哚普利联合螺内酯治疗慢性心力衰竭的临床疗效及其对患者神经内分泌的影响
摘要
目的探讨培哚普利联合螺内酯治疗慢性心力衰竭的临床疗效及其对患者神经内分泌的影响。方法选取2015—2016年于江苏省人民医院住院部收治的慢性心力衰竭患者100例,随机分为对照组和观察组,各50例。对照组患者采用培哚普利治疗,观察组患者在对照组基础上联合螺内酯治疗。比较两组患者治疗前后心功能指标[左心室射血分数(LVEF)、心胸比、心率及心肌耗氧量],治疗前及治疗1、2、5个月后神经内分泌指标[N末端B型脑钠肽(NT-proBNP)、醛固酮(Aldo)、血管紧张素Ⅱ(AngⅡ)及肾素(PRA)]改善情况,观察患者治疗期间不良反应发生情况及临床疗效。结果治疗前,两组患者LVEF、心胸比、心率及心肌耗氧量比较,差异无统计学意义(P>0.05);治疗后,观察组患者LVEF高于对照组,心胸比、心率及心肌耗氧量低于对照组(P<0.05)。治疗前,两组患者NT-proBNP、AngⅡ、PRA水平比较,差异无统计学意义(P>0.05);治疗1、2、5个月后,观察组患者NT-proBNP、AngⅡ、PRA水平低于对照组(P<0.05);治疗前及治疗1个月后,两组患者Aldo水平比较,差异无统计学意义(P>0.05);治疗2、5个月后,观察组患者Aldo水平低于对照组(P<0.05)。患者治疗期间均未出现严重不良反应,且观察组患者的临床疗效优于对照组(P<0.05)。结论采用培哚普利联合螺内酯治疗慢性心力衰竭的临床疗效确切,可有效改善患者心功能及神经内分泌,且安全性高。
引文
[1]卢志南,黄洁,孙兴国,等.终末期慢性心力衰竭患者运动中摄氧通气效率指标的临床应用[J].中华心血管病杂志,2015,43(1):44-50.DOI:10.3760/cma.j.issn.0253-3758.2015.01.009.
[2]Guyatt GH,Sullivan MJ,Thompson PJ,et al.The 6-minute walk:a new measure of exercise capacity in patients with chronic heart failure[J].Canadian Medical Association Journal,1985,132(8):919.
[3]张长江,李元红.血浆NT-pro BNP联合6min步行试验法在慢性心力衰竭诊断中的应用价值[J].中西医结合心脑血管病杂志,2016,14(2):178-179.
[4]Merit-HF Study Group.Effect of metoprolol CR/XL in chronic heart failure:metoprolol CR/XL randomised intervention trial in-congestive heart failure(MERIT-HF)[J].The Lancet,1999,353(9169):2001-2007.
[5]European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease Investigators.Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease:randomised,double-blind,placebo-controlled,multicentre trial(the EUROPA study)[J].The Lancet,2003,362(9386):782-788.
[6]Duboc D,Meune C,Lerebours G,et al.Effect of perindopril on the onset and progression of left ventricular dysfunction in Duchenne muscular dystrophy[J].Journal of the American College of Cardiology,2005,45(6):855-857.
[7]张盈涛,苌新明,李欣,等.螺内酯对肝纤维化大鼠Ⅰ/Ⅲ型胶原蛋白表达的影响[J].世界华人消化杂志,2001,9(10):1120-1124.
[8]Edelmann F,Wachter R,Schmidt AG,et al.Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction:the Aldo-DHF randomized controlled trial[J].Jama,2013,309(8):781-791.
[9]Matsumoto Y,Mori Y,Kageyama S,et al.Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients[J].Journal of the American College of Cardiology,2014,63(6):528-536.
[2]Guyatt GH,Sullivan MJ,Thompson PJ,et al.The 6-minute walk:a new measure of exercise capacity in patients with chronic heart failure[J].Canadian Medical Association Journal,1985,132(8):919.
[3]张长江,李元红.血浆NT-pro BNP联合6min步行试验法在慢性心力衰竭诊断中的应用价值[J].中西医结合心脑血管病杂志,2016,14(2):178-179.
[4]Merit-HF Study Group.Effect of metoprolol CR/XL in chronic heart failure:metoprolol CR/XL randomised intervention trial in-congestive heart failure(MERIT-HF)[J].The Lancet,1999,353(9169):2001-2007.
[5]European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease Investigators.Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease:randomised,double-blind,placebo-controlled,multicentre trial(the EUROPA study)[J].The Lancet,2003,362(9386):782-788.
[6]Duboc D,Meune C,Lerebours G,et al.Effect of perindopril on the onset and progression of left ventricular dysfunction in Duchenne muscular dystrophy[J].Journal of the American College of Cardiology,2005,45(6):855-857.
[7]张盈涛,苌新明,李欣,等.螺内酯对肝纤维化大鼠Ⅰ/Ⅲ型胶原蛋白表达的影响[J].世界华人消化杂志,2001,9(10):1120-1124.
[8]Edelmann F,Wachter R,Schmidt AG,et al.Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction:the Aldo-DHF randomized controlled trial[J].Jama,2013,309(8):781-791.
[9]Matsumoto Y,Mori Y,Kageyama S,et al.Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients[J].Journal of the American College of Cardiology,2014,63(6):528-536.