卡维他洛联合螺内酯对慢性心力衰竭患者疗效及对BNP和GSH-PX的影响  

Influencing on the Carvedilol his Los spironolactone in patients with chronic heart failure and its effect on the BNP and GSH-PX

作　　者：张守龙 

机构地区：[1]山东淄博市张店区人民医院心内科,山东淄博255000

出　　处：《现代预防医学》2012年第20期5445-5446,5449,共3页Modern Preventive Medicine

摘　　要：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 separate term efficacy of carvedilol his Los carvedilol his Los spironolactone for the treatment of patients with chronic heart failure and BNP and GSH-PX. METHODS A total of 80 patients with chronic heart failure patients, and they were divided into two groups. Group A received the conventional therapy of diuretics and angiotensin conversion enzyme inhibitors, while patients received carvedilol his Luo treatment alone; Group B received the conventional treatment and spironolactone. RESULTS The total efficiency in group B was significantly better than group A, the total effi ciency were 70.0% and 95.0% respectively, and the difference was statistically significant （P 〈 0.05） ; When comparing the serum BNP and GSH-PX between two groups, the level of GSH-PX of carvedilol jointly grant the spironolactone group was sig nificandy higher than that of the separate carvedilol carvedilol group. BNP levels were significantly lower than the separate carvedilol carvedilol group, and the difference was statistically significance （P 〈 0.05） ; When comparing the LVEF, LVEDD with LVESD, the LVEDD and LVESD were significantly decreased compared with before treatment （P 〈 0.05）. LVEF signifi cantly increased after treatment than before treatment （P 〈 0.05） ; LVEDD and LVESD in the card dimension to Los joint give the spironolactone group significantly reduced than separate carvedilol group, while the LVEF was increased. There was signifi cant difference （P 〈 0.05）. CONCLUSION For patients with chronic heart failure, carvedilol combined grant spironolactone treatment was significantly superior to the use of carvedilol alone, that type of patients with early joint use of carvedilol and spironolactone significantly improved cardiac function, and reduced the patient died rates and improved long-term prognosis, which is worthy of clinical application.

关 键 词：卡维他洛 螺内酯 慢性心力衰竭 BNP GSH-PX 

分 类 号：R541.6[医药卫生—心血管疾病]