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目的探讨单独使用卡维他洛与卡维他洛联合螺内酯对慢性心力衰竭患者治疗的近期疗效及对BNP和GSH-PX的影响。方法共纳入80例慢性心力衰竭患者,平均分为两组,A组采取利尿剂和血管紧张素转化酶抑制剂等常规治疗,同时给予患者单独使用卡维他洛治疗;B组在A组基础上加用螺内酯治疗。结果 B组(卡维地洛联合给予螺内酯组)明显优于A组(单独卡维地洛组),总有效率分别为70.0%及95.0%,差异有统计学意义(P﹤0.05);两组间血清BNP、GSH-PX比较,卡维地洛联合给予螺内酯组GSH-PX水平明显高于单独卡维地洛组,BNP水平明显低于单独卡维地洛组,差异均有统计学意义(P﹤0.05);LVEF、LVEDD及LVESD比较,治疗后LVEDD及LVESD均较治疗前减少(P﹤0.05),治疗后LVEF较治疗前增高(P﹤0.05);治疗后两组比较,卡维地洛联合给予螺内酯组较单独卡维地洛组LVEDD及LVESD减少更显著,LVEF增高亦更明显,差异均有统计学意义(P﹤0.05)。结论对于慢性心力衰竭患者,卡维地洛联合给予螺内酯治疗效果明显优于单独使用卡维地洛,对该类患者早期联合使用卡维地洛及螺内酯可以明显改善患者的心功能,降低患者病死率,改善长期预后,值得临床推广应用。
Objective To investigate the short-term curative effect and the effect of BNP and GSH-PX on the treatment of patients with chronic heart failure treated with capecitabine and capecitabine alone. Methods A total of 80 patients with chronic heart failure were enrolled and equally divided into two groups. Patients in group A received routine treatment with diuretics and angiotensin-converting enzyme inhibitors, and were treated with carvedilol alone. In group B, On the use of spironolactone treatment. Results The total effective rate of group B (carvedilol combined with spironolactone) was significantly higher than that of group A (carvedilol alone), with a total effective rate of 70.0% and 95.0%, respectively, with statistical significance (P <0.05); Serum levels of BNP and GSH-PX in serum were significantly higher in carvedilol-treated spironolactone group than in carvedilol alone group, and the level of BNP was significantly lower than that in carvedilol alone group (P <0.05). Compared with LVEF, LVEDD and LVESD, LVEDD and LVESD in treatment group were significantly lower than those before treatment (P <0.05), LVEF increased after treatment (P <0.05) Compared with the carvedilol alone group, the decrease of LVEDD and LVESD was more significant and the increase of LVEF was more obvious in the combination of dextro-losanone group and spironolactone group (P <0.05). Conclusions In patients with chronic heart failure, the combination of carvedilol and spironolactone is superior to carvedilol alone. Early combination of carvedilol and spironolactone can significantly improve cardiac function and reduce mortality in patients with chronic heart failure Rate, improve long-term prognosis, it is worth clinical application.