坦索罗辛与非那雄胺对老年男性心力衰竭患者血压昼夜节律及心功能的影响  

Influence of tamsulosin and finasteride on circadian rhythm and cardiac function in male elderly patients with chronic heart failure

作　　者：邓雪峰[1] 彭妙官[1] 陈广原[1] 

机构地区：[1]广州医科大学附属第一医院老年病科,广东省广州市510120

出　　处：《实用老年医学》2014年第9期755-757,共3页Practical Geriatrics

摘　　要：目的观察坦索罗辛与非那雄胺对伴良性前列腺增生的老年慢性心力衰竭患者血压昼夜节律及心功能的影响。方法 122例伴良性前列腺增生的老年慢性心力衰竭患者随机分为对照组(n=60)和治疗组(n=62)。对照组接受基础疾病及抗心力衰竭治疗,治疗组在此基础上服用坦索罗辛和(或)非那雄胺,治疗组根据服用药物分为A组(服用坦索罗辛,n=22)、B组(服用非那雄胺,n=20)及C组(服用非那雄胺+坦索罗辛,n=20),共观察12月。治疗前后行6-min步行试验(6-MWT)、动态血压及前列腺体积测定。结果 (1)12月后,2组的6-MWT均有改善,治疗组改善尤为显著(P<0.01);治疗组各亚组在6-MWT改善方面差异无统计学意义。(2)治疗组纠正血压昼夜节律异常(由非杓型纠正为杓型)比例显著高于对照组(P<0.05);治疗组各亚组间差异无统计学意义。(3)研究结束时,对照组的前列腺体积增大,治疗组的前列腺体积缩小,2组比较差异有统计学意义(P<0.01);非那雄胺在缩小前列腺体积方面优势明显。结论坦索罗辛与非那雄胺有改善心力衰竭患者心脏功能的作用,老年男性慢性心力衰竭患者应行药物积极干预良性前列腺增生。Objective To observe the effects of tamsulosin and finasteride on circadian blood pressure rhythm and cardiac function in male elderly patients with chronic heart failure（CHF） and benign prostatic hyperplasia（BPH）. Methods A total of 122 patients with CHF complicated with BPH were enrolled in this study,and randomly divided into control group（n = 60） and treatment group（n = 62）. The control group received routine treatment for basic diseases and CHF,and the treatment group received tamsulosin and（ or） finasteride additionally. The treatment group were further divided into group A（receiving tamsulosin）,group B（ receiving finasteride） and group C（ receiving tamsulosin and finasteride）. The study continued for 12 months. 6-minute walk test（6-MWT）,24-hour ambulatory blood pressure and prostate volume were determinated before and after treatment. Results After 12 months＇ treatment,the level of 6-MWT was improved both in control group and treatment group,especially in the treatment group（ P〈0. 05）. The transforming incidence of circadian rhythm from non-dipper to dipper was 71. 0% in treatment group,compared with 43. 3% in the control group（P〈0. 05）.There were no significant differences in 6-MWT and transforming rate of circadian rhythm among group A,B and C（ P〉 0. 05）. The prostatic volume became smaller in treatment group,while becoming larger in control group（P 〈0. 01）; Compared with group A,the prostatic volume was more significantly reduced in group B and group C. Conclusions Tamsulosin and finasteride can improve cardiac function in the patients with CHF complicated with BPH.

关 键 词：慢性心力衰竭 良性前列腺增生 动态血压 

分 类 号：R541.6[医药卫生—心血管疾病]