螺内酯治疗高血压病并左心室舒张功能不全的观察  

Effects of spironolactone on cardiac diastolic function in patients with hypertension accompanied with left ventricular diastolic dysfunction

作　　者：余浩[1] 陈苏[1] 胡晓军[1] 孙跃玲[1] 李峰[1] 晏凯利[1] 彭慧[1] 刘汉华[1] 涂远超[1] 

机构地区：[1]湖北省新华医院心内科,武汉湖北430015

出　　处：《心血管康复医学杂志》2011年第1期75-78,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察螺内酯对高血压病合并无症状性左心室舒张功能不全的影响。方法:选择高血压病合并无症状性左心室舒张功能不全患者共126例,随机分为常规治疗组(68例)和螺内酯组(58例)。两组患者均按常规综合治疗,而螺内酯组在此基础上加用螺内酯片治疗。治疗前后观察患者血压、心率的变化,以彩色多普勒超声仪检测E峰(EV)、A峰(AV)、舒张期左房内径(LADd)、舒张期左室内径(LVDd)、左室射血分数(LVEF)等指标。结果:治疗前、后两组平均心率、平均收缩压、平均舒张压无明显差异(P>0.05),LADd、LVDd、LVEF等指标也均无明显差异(P>0.05);但螺内酯组EV值明显高于常规治疗组[(78±17)cm/s∶(62±11)cm/s,P<0.05],AV值显著低于常规治疗组[(55±12)cm/s∶(64±16)cm/s,P<0.05],同时螺内酯组E/A值显著高于常规治疗组[(1.42±0.36)∶(0.98±0.28),P<0.01]。结论:螺内酯能显著改善高血压病合并无症状左室舒张功能不全患者的心舒张功能,而且独立于降压以外。Objective：To explore the effects of spironolactone on cardiac diastolic function in patients with hypertension accompanied with left ventricular diastolic dysfunction.Methods：A total of 126 patients with hypertension accompanied with left ventricular diastolic dysfunction and without any symptoms were involved in the study.They were randomly divided into routine treatment（control） group（n=68） and spironolactone group（n=58）.Both two groups were given routine treatment and spironolactone group were given spironolactone additionally.Before and after treatment,the blood pressure,heart rate were monitored;the E peak（EV） and A peak（AV） detected in color Doppler echocardiography,and left atrial diastolic dimension（LADd）,left ventricular diastolic dimension（LVDd） and left ventricular ejection fraction（LVEF） detected by echocardiography in all patients.Results：Before and after treatment,the mean heart rate,blood pressure,LADd,LVDd and LVEF of two groups showed no significant difference（P0.05）.After treatment,EV value of spironolactone group was significantly higher than that of control group [（78±17） cm/s vs.（62±11） cm/s,P 0.05],AV value was significantly lower than that of control group [（55±12） cm /s vs.（64±16） cm/s,P0.05] and E/A value was significantly higher than that of control group [（1.42±0.36） vs.（0.98±0.28）,P0.01].Conclusion：Spironolactone can significantly improve heart diastolic function in patients with hypertension accompanied with left ventricular diastolic dysfunction,and it′s independent to lowing blood pressure.

关 键 词：螺内酯 高血压 心室功能 左 

分 类 号：R544.1[医药卫生—心血管疾病]