螺内酯对老年人轻度心力衰竭心肌纤维化和心功能的影响  

Effects of spironolactone on myocardial fibrosis and left ventricular function in old patients with mild heart failure

作　　者：毛艳华[1] 张莉娜[2] 石斗飞[2] 刘肖林[1] 

机构地区：[1]滨州医学院老年病教研室,山东滨州256603 [2]滨州医学院附属医院老年病科

出　　处：《心血管康复医学杂志》2007年第1期57-60,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨螺内酯对老年人轻度心力衰竭心肌纤维化和心功能的影响。方法:选择老年轻度心力衰竭患者(NYHA心功能分级为Ⅰ～Ⅱ级)67例为观察组,再随机分为常规治疗组(33例)和螺内酯组(34例);另健康对照组20例,治疗前和治疗3个月时采用放射免疫法测定血清Ⅲ型前胶原氨基半端肽(PⅢNP)和血浆脑钠肽(BNP)浓度,并应用心脏彩超测定心功能变化。结果:观察组血清PⅢNP和血浆BNP浓度均高于对照组(P<0.01);3个月后与治疗前比较:螺内酯组血PⅢNP和BNP均明显下降(P<0.01);且较常规治疗组亦明显下降(P<0.05,<0.01)。结论:在老年人轻度心力衰竭患者小剂量螺内酯治疗可以起到抗心肌纤维化、改善心功能的作用。Objective： To evaluate the effects of spironolactone on myocardial fibrosis and left ventricular function in old patients with mild chronic heart failure. Methods： The subjects were divided into investigation group （67 patients with mild chronic heart failure） and health control group （n=20）. Serum levels of aminoterminl propeptide of type Ⅲ procollagen （PⅢNP） and brain natriuretic peptide （BNP） were measured through radioimmunoassay. The investigation group was further subdivided into either conventional or conventional plus spironolactone groups. After 3 months therapy, PⅢNP and BNP were re-checked and the data of ventricular function were measured by echocardiography. Resuits： The serum levels of PⅢNP and BNP were higher than those of health control group （P〈0.01）. Three months after treatment the levels of PⅢNP and BNP significant decreased （P〈0.01） in spironolactone group, and also significantly lower than those of conventional group （P〈0.05, 〈0.01, respectively）. Conclusion： The finding indicates that the spironolactone therapy can suppress myocardial fibrosis and improve left ventricular function in old patients.

关 键 词：心力衰竭 充血性 螺内酯 心内膜心肌纤维化症 

分 类 号：R541.61[医药卫生—心血管疾病]