【摘要】 目的探讨螺内酯联合琥珀酸美托洛尔缓释片治疗舒张性心力衰竭(DHF)的临床效果。方法 60例DHF患者分为观察组和对照组,每组30例。2组患者在常规治疗的基础上,对照组患者给予琥珀酸美托洛尔缓释片治疗,观察组患者给予螺内酯联合琥珀酸美托洛尔缓释片治疗,治疗12个月后观察2组患者心功能改善情况。结果与治疗前比较,治疗后2组患者心功能均显著改善,差异有统计学意义(P<0.05);治疗后观察组患者心功能改善显著优于对照组,差异有统计学意义(P<0.05)。治疗后2组患者左心室舒张末期内径(LVEDD)、A峰血流速度、左心房内径(LAD)显著低于治疗前(P<0.05),而E峰血流速度、E峰血流速度/A峰血流速度(E/A)、6 min步行距离(6MWD)显著高于治疗前(P<0.05);2组患者治疗前后心脏射血分数比较差异均无统计学意义(P>0.05)。治疗后观察组患者LVEDD、A峰血流速度、LAD显著低于对照组(P<0.05),而E峰血流速度、E/A、6MWD显著高于对照组(P<0.05)。对照组治疗前后患者血清I型前胶原羧基端肽(PICP)、N-末端脑钠肽前体(NT-proBNP)和醛固酮(ALD)水平比较差异均无统计学意义(P>0.05);治疗后观察组患者血清PICP、NT-proBNP和ALD水平显著低于治疗前,差异有统计学意义(P<0.05);治疗后观察组患者血清PICP、NT-proBNP和ALD水平显著低于对照组,差异有统计学意义(P<0.05)。结论螺内酯联合琥珀酸美托洛尔缓释片治疗DHF可显著改善患者心脏的舒张功能。更多还原

【Abstract】 Objective To observe the effect of spironolactone combined with metoprolol succinate sustained-release tablets on diastolic heart failure(DHF).Methods A total of 60 patients with DHF were divided into observation group and control group,30 patients in each group.Based on conventional therapy,the patients in control group were treated with metoprolol succinate sustained-release tablets,the patients in observation group were treated with metoprolol succinate sustained-release tablets and spironolactone.The improvement of heart function was observed in the two groups 12 months after treatment.Results The heart function of patients in the two groups improved significantly after treatment(P < 0.05).The improvement of heart function in observation group was more than that in control group after treatment(P < 0.05).The left ventricular enddiastolic dimension(LVEDD),A peak flow velocity and left atrial dimension(LAD) after treatment were significantly lower than those before treatment in the two groups(P < 0.05).But the E peak flow velocity,E /A and 6-minute walk distance(6MWD) after treatment were significantly higher than those before treatment in the two groups(P <0.05).There was no significant difference in cardiac ejection fraction between the two groups before and after treatment(P > 0.05).The LVEDD,A peak flow velocity and LAD in observation group were significantly lower than those in control group after treatment(P <0.05).The E peak flow velocity,E /A and 6MWD in observation group were significantly higher than those in control group after treatment(P < 0.05).There was no significant difference in the levels of carboxy terminal propeptide of type I procollagen(PICP),N-terminal pro brain natriuretic peptide(NT-proBNP) and aldosterone(ALD) before and after treatment in control group(P > 0.05).The levels of PICP,NT-proBNP and ALD after treatment were significantly lower than those before treatment in observation group(P < 0.05).The levels of PICP,NT-proBNP and ALD in observation group were significantly lower than those in control group after treatment(P < 0.05).Conclusion Spironolactone combined with metoprolol can significantly improve cardiac diastolic function in patients with DHF.更多还原