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目的探讨螺内酯联合呋塞米治疗老年舒张性心力衰竭的临床疗效。方法选取2013年12月—2015年12月犍为县中医医院收治的100例老年舒张性心力衰竭患者,按随机数字法分为对照组和试验组,每组50例。对照组患者给予呋塞米治疗,试验组患者给予螺内酯联合呋塞米治疗。比较两组患者NYHA分级、左室射血分数(LVEF)、左室舒张末内径(LVEDd)、左室壁节段运动情况〔室壁运动平均收缩期运动速度(Sm)和舒张期早期运动速度(Em)〕、心力衰竭再住院及电解质紊乱情况等。结果治疗前两组患者NYHA分级、LVEF及LVEDd比较,差异无统计学意义(P>0.05);治疗后试验组患者NYHA分级低于对照组,LVEF高于对照组,LVEDd小于对照组,差异有统计学意义(P<0.05)。治疗前两组患者室壁节段运动情况比较,差异无统计学意义(P>0.05);治疗后试验组患者Sm、Em均小于对照组,差异有统计学意义(P<0.05)。两组心力衰竭再住院及由解质紊乱发生率比较,差异无统计学意义(P>0.05)结论螺内酯联合呋塞米治疗老年舒张性心力衰竭的临床疗效显著,可显著改善患者心功能。
Objective To investigate the clinical efficacy of spironolactone combined with furosemide in the treatment of elderly patients with diastolic heart failure. Methods From December 2013 to December 2015, 100 cases of elderly patients with diastolic heart failure admitted to the Chinese Medicine Hospital were divided into control group and trial group according to random number method, 50 cases in each group. Control group patients given furosemide treatment, test group patients given spironolactone combined with furosemide treatment. NYHA classification, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), segmental left ventricular wall motion (mean wall motion mean systolic velocity (Sm) and early diastolic velocity (Em)〕, heart failure and hospitalization and electrolyte imbalance. Results There was no significant difference in the NYHA classification, LVEF and LVEDd between the two groups before treatment (P> 0.05). After treatment, NYHA classification in the test group was lower than that in the control group, LVEF was higher than that in the control group, LVEDd was smaller than the control group, Statistical significance (P <0.05). There was no significant difference in wall motion between the two groups before treatment (P> 0.05). Sm and Em in the experimental group were significantly lower than those in the control group after treatment (P <0.05). There were no significant differences between the two groups in rehospitalization and the incidence of dislocation of the quality of life (P> 0.05). Conclusion The clinical efficacy of spironolactone combined with furosemide in the treatment of elderly patients with diastolic heart failure is significant and can significantly improve the cardiac function.