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目的观察小剂量螺内酯对糖尿病肾病并左室射血分数正常心力衰竭患者左心室功能的影响。方法选择诊断为糖尿病肾病并左室射血分数正常心力衰竭患者120例,随机分为研究组与对照组各60例。对照组采用常规内科治疗。研究组在对照组治疗基础上给予螺内酯治疗,治疗4个月后观察治疗前后的心脏超声心动参数变化。结果治疗前,研究组与对照组心脏超声检查指标差异无统计学意义(P>0.05)。治疗后2组患者左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVEDS)、左室射血分数(LVEF)、左心房内径(LAD)与治疗前比较差异无统计学意义(P>0.05)。2组治疗后二尖瓣舒张早期血流充盈速度/二尖瓣舒张晚期血流充盈速度(E/A)比值均大于治疗前,且研究组大于对照组,差异均有统计学意义(P<0.05);二尖瓣舒张早期血流充盈速度/二尖瓣环舒张早期运动峰速度(E/Ea)均小于治疗前,且研究组小于对照组,差异均有统计学意义(P<0.05)。结论螺内酯能够改善糖尿病肾病左室射血分数正常心力衰竭患者心脏功能。
Objective To observe the effect of low dose spironolactone on left ventricular function in patients with diabetic nephropathy and normal heart failure with left ventricular ejection fraction. Methods 120 patients with diabetic nephropathy and normal heart failure with left ventricular ejection fraction were randomly divided into study group and control group with 60 cases each. Control group using conventional medical treatment. The study group was given spironolactone treatment on the basis of the control group. The echocardiographic parameters before and after the treatment were observed after 4 months of treatment. Results Before treatment, there was no significant difference in echocardiographic parameters between study group and control group (P> 0.05). There was no significant difference in LVEDD, LVEDS, LVEF and LAD between the two groups after treatment (P> 0.05). The rates of mitral early diastolic filling velocity / mitral early diastolic filling velocity (E / A) ratio in both groups were significantly higher than those before treatment, and the study group was larger than the control group (P < 0.05); mitral early diastolic flow filling rate / mitral annular early diastolic peak velocity (E / Ea) were less than before treatment, and the study group was smaller than the control group, the difference was statistically significant (P <0.05) . Conclusion Spironolactone can improve cardiac function in patients with diabetic nephropathy and normal heart failure with left ventricular ejection fraction.