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目的研究醛固酮拮抗剂——螺内酯(Spironolactone)对慢性左室收缩功能障碍患者左室功能的影响。方法将125例以慢性左室收缩功能障碍为主的充血性心力衰竭患者随机分成治疗组61例和对照组64例。对照组采用常规抗心力衰竭治疗,治疗组在此基础上加用螺内酯,剂量为10～40mg/d。治疗前后超声心动图检测左室收缩末期容积(LVESV)、左室舒张末期容积(LV-EDV)和射血分数(LVEF)。结果对照组治疗后较治疗前LVESV下降,LVEF升高(P均<0.05);治疗组治疗后较治疗前LVEF升高,LVESV下降,心功能改善(P均<0.05),且LVESV及心功能级别与对照组治疗后比较差异有统计学意义(P均<0.05)。结论螺内酯通过阻断醛固酮,明显改善充血性心力衰竭患者左室收缩功能,在心力衰竭治疗中加用螺内酯可改善慢性充血性心力衰竭患者的预后。
Objective To investigate the effect of aldosterone antagonist Spironolactone on left ventricular function in patients with chronic left ventricular systolic dysfunction. Methods A total of 125 patients with congestive heart failure with chronic left ventricular systolic dysfunction were randomly divided into treatment group (61 cases) and control group (64 cases). The control group was treated with conventional anti-heart failure. The treatment group was treated with spironolactone at the dosage of 10-40 mg / d. Before and after treatment, left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LV-EDV) and ejection fraction (LVEF) were measured by echocardiography. Results After treatment, LVESV and LVEF in control group were significantly lower than those before treatment (all P <0.05). LVEF, LVESV and LVESV in treatment group were significantly higher than those before treatment (P <0.05), LVESV and heart function The difference between the two groups was statistically significant (P <0.05). Conclusion Spironolactone can significantly improve left ventricular systolic function in patients with congestive heart failure by blocking aldosterone. Spironolactone can improve the prognosis of patients with chronic congestive heart failure in the treatment of heart failure.