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常规应用螺内酯联合依那普利治疗老年扩张型心肌病心力衰竭(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第2期
页码:
228-230
栏目:
临床研究
出版日期:
2006-03-01

文章信息/Info

Title:
Spironolactone combined with Enalapril in treatment of heart failure of dilated cardiomyopathy in elders
作者:
毕四锐
延安大学附属医院干部病房, 陕西 延安 716000
Author(s):
BI Si-rui
Cadre ward, Hospital of Yan′an University,Yan′an, Shaanxi 716000,China
关键词:
扩张型心肌病老年人螺内酯依那普利心电描记术动态超声心动图描记术
Keywords:
dilated cardiomyopathy elder spironolactone enalapril electrocardiographyambulatory ultrasound cardiography
分类号:
R542.2
DOI:
-
文献标识码:
A
摘要:
目的 评价螺内酯联合依那普利治疗老年人扩张型心肌病(DCM)心力衰竭的有效性和安全性。方法 以148例老年DCM心力衰竭患者作研究对象,按随机化原则分为观察组(74例)和对照组(74例)。对照组为依那普利,加上基础用药(地高辛、双氢克尿噻);观察组为对照组用药加上螺内酯。治疗6周后复查两组的动态心电图、超声心动图。结果 治疗后两组的左室射血分数(LVEF)均有增加,左室收缩末期容积(LVESV)和左室舒张末期容积(LVEDV)均有减少,24 h 室性早搏(VA)数也均有减少;观察组与对照组比较,LVEF显著增加。两组均未发现高血钾及肝肾功能损害。结论 在老年DCM心力衰竭常规用药的基础上,常规加用螺内酯联合依那普利的治疗有效、安全,可显著改善左室重构和防治猝死。
Abstract:
AIM To evaluate the efficiency and safety of Spironolactone combined with Enalapril in the treatment of heart failure of dilated cardiomyopathy (DCM) in elders. METHODS 148 elders with heart failure of DCM were randomly divided into the observation group (n=74) and control group (n=74). Patients in control group were treated with Enalapril plus digoxin and hydrochlorothiazide and patients in observation group were treated with drugs used in control group plus Spironolactone. After 6 week treatment, Holter and ultrasound cardiography were performed. RESULTS After treatment, patients in two groups showed increased left ventricular ejection fraction (LVEF), decreased left ventricular enddiastolic volume (LVEDV) and decreased times of ventricular arrhythmia in 24 h. Compared with the control group, the changes were more significant in observation group( P<0.05 ). No hyperopotassium and impairment of liver and kidney functuins found in either group. CONCLUSION Spironolactone combined with Enalapril plus basic drugs benefit the reconstruction of left ventricular and effectively prevent sudden death.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期:2004-11-08.作者简介:毕四锐,副主任医师 Tel:(0911)2234848
更新日期/Last Update: