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目的:观察小剂量螺内酯联合美托洛尔对慢性心力衰竭患者血浆NT-p roBNP、CRP水平及心功能的影响。方法:将71例慢性心力衰竭(心衰)患者随机分为治疗组和对照组,均予常规抗心衰治疗,治疗组加服小剂量螺内酯联合美托洛尔,疗程12周。治疗前后用彩超测定心功能指标左心室射血分数(LVEF),ELISA法和散射比浊法测定血浆N2末端脑钠肽前体(NT-p roBNP)、C反应蛋白(CRP)水平。结果:治疗后治疗组总有效率明显高于对照组,心功能指标LVEF明显升高,血浆NT-p roBNP、CRP水平均明显下降,P均<0.05;治疗组血浆NT-p roBNP与LVEF呈负相关(r=-0.75,P<0.05);血浆CRP水平与LVEF增加呈负相关(r=-0.433,P<0.05)。结论:小剂量螺内酯联合美托洛尔治疗慢性心衰效果确切,其主要作用机制为降低血浆NT-p roBNP、CRP水平和改善心功能。
Objective: To observe the effects of low dose spironolactone combined with metoprolol on plasma NT-p roBNP, CRP levels and cardiac function in patients with chronic heart failure. Methods: Seventy-one patients with chronic heart failure (HF) were randomly divided into treatment group and control group. All patients were given conventional anti-heart failure treatment. The treatment group received low-dose spironolactone combined with metoprolol for 12 weeks. The levels of plasma N-terminal pro brain natriuretic peptide (NT-p roBNP) and C-reactive protein (CRP) were measured by color Doppler ultrasonography before and after treatment with left ventricular ejection fraction (LVEF), ELISA and nephelometry. Results: After treatment, the total effective rate of the treatment group was significantly higher than that of the control group. The cardiac function index LVEF was significantly increased, and the plasma levels of NT-p roBNP and CRP were significantly decreased (P <0.05). The plasma levels of NT-p roBNP and LVEF (R = -0.75, P <0.05). Plasma CRP level was negatively correlated with the increase of LVEF (r = -0.433, P <0.05). CONCLUSIONS: Small doses of spironolactone combined with metoprolol have definite effect on chronic heart failure. The main mechanism of action is to decrease plasma NT-p roBNP, CRP level and improve cardiac function.