本研究旨在通过测定冠状动脉支架植入术患者手术前、后血清GATA4蛋白、低氧诱导因子-1α(HIF-1α)水平的变化,探讨螺内酯对缺血性心肌病行冠状动脉支架植入术患者的心脏功能保护作用.通过PSM分组方法回顾性的选取2019年3月到2020年3月在我院接受缺血性心肌病行冠状动脉支架植入术患者134例,其中服用螺内酯组患者67例作为实验组,未服用螺内酯患者67例作为对照组.两组患者均在冠状动脉支架植入术术前、术后第24小时及术后半年测定血清中肌钙蛋白Ⅰ、GATA4蛋白、HIF-1α水平;两组患者在术前及术后半年分别进行常规经胸心脏彩超检查,测量LVEF等数值,并对动态心脏超声图像进行左心室收缩期峰值整体纵向应变(global longitudinal strain,GLS)进行测量.结果发现,HIF-1α水平:实验组和对照组在术前、术后半年无显著差异,但实验组在术后第24小时HIF-1α低于对照组(P＜0.01).GATA4蛋白:实验组和对照组在术前、术后第24小时无显著差异,但实验组在术后半年明显低于对照组(P＜0.01);两组患者术前及术后LVEF无显著差异,但术后半年两组GLS较术前均有改善,且螺内酯组GLS改善更显著(P＜0.05).因此可知,螺内酯可能具有改善心肌缺氧及抑制心肌重构从而改善心功能的作用.“,”In the present study,we aimed to explore the protective effect of spironolactone on cardiac function in patients undergoing coronary stent implantation by determining the serum levels of GATA4 and hypoxia-inducible factor-1α(HIF-1α)proteins before and after the coronary stent implantation.A total of 134 patients undergoing coronary stent implantation in our hospital from March 2019 to March 2020 were retrospectively selected using the propensity score matching(PSM)method.Of the 134 patients,67 patients taking spironolactone were used as a test group,and the other 67 patients without taking spironolactone were used as a control group.In all patients,the levels of serum GATA4,HIF-1α,and troponin Ⅰ proteins were determined before as well as 24 h and 6 months after the coronary stent implantation.Left ventricular ejection fraction(LVEF)and left ventricular systolic global longitudinal strain(GLS)were determined before and 6 months after the coronary stent implantation.There were no significant differences in the HIF-1α level between the two groups before and 6 months after the operation,while the HIF-1αlevel was significantly lower in the test group compared with the control group at 24 h after the operation(P＜0.01).There were no significant differences in the GATA4 protein level between the two groups before and 24 h after the operation,while the GATA4 protein level was significantly lower in the test group compared with the control group at 6 months after the operation(P＜0.01).There was no significant difference in LVEF between the two groups before and 6 months after the operation.GLS was significantly improved at 6 months after the operation compared with that before the operation in both groups,while GLS was significantly better in the test group compared with the control group at 6 months after the operation(P＜0.01).Collectively,spironolactone could protect cardiac function probably by improving myocardial hypoxia and inhibiting myocardial remodeling.