螺内酯联合卡托普利片、单硝酸异山梨酯治疗重度COPD合并肺心病疗效及对心功能、血气水平的影响  

Effect of spironolactone combined with captopril tablets and isosorbide mononitrate in the treatment of severe COPD complicated with pulmonary heart disease and the influence on cardiac function and blood gas

作　　者：孙华聪 王雯 董红超 SUN Hua-cong;WANG Wen;DONG Hong-chao(Department of Respiratory Medicine,Brain Hospital,Liaocheng People's Hospital;Department of Respiratory Medicine,Liaocheng People's Hospital,Liaocheng 252000,Shandong,China)

机构地区：[1]聊城市人民医院脑科医院呼吸内科 [2]聊城市人民医院呼吸内科,山东聊城252000

出　　处：《川北医学院学报》2023年第2期221-224,共4页Journal of North Sichuan Medical College

基　　金：山东省聊城城市人民医院院级青年科研基金(LYON202103)。

摘　　要：目的:研究螺内酯联合卡托普利片、单硝酸异山梨酯治疗重症慢性阻塞性肺疾病(COPD)合并肺心病患者的临床疗效及对其心功能、血气水平的影响。方法:根据治疗方式不同将106例重症COPD合并肺心病患者分为对照组(n=53)和试验组(n=53);对照组螺内酯联合硝酸异山梨酯治疗,试验组螺内酯联合卡托普利片、单硝酸异山梨酯治疗,比较两组临床疗效、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、超敏C-反应蛋白(hs-CRP)、B型利尿钠肽(BNP)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))血氧饱和度(SpO_(2))、用力肺活量(FVC)、第1s用力呼气末容积(FEV1)及FEV1/FVC水平。结果:试验组总有效率高于对照组(P<0.05);试验组LVEDD、hs-CRP、BNP水平及PaCO_(2)水平均低于对照组(P<0.05);试验组LVEF、PaO_(2)、SpO_(2)、FVC、FEV1及FEV1/FV水平均高于对照组(P<0.05)。结论:螺内酯联合卡托普利片、单硝酸异山梨酯可有效改善重症COPD合并肺心病患者心肺功能及血气指标。Objective:To study the clinical effect of spironolactone combined with captopril tablets and isosorbide mononitrate in the treatment of patients with severe chronic obstructive pulmonary disease(COPD) and pulmonary heart disease, and the influence on cardiac function and blood gas.Methods:106 patients with severe COPD and cor pulmonaleum were divided into control group(n=53) and experimental group(n=53) according to different treatment methods.Spironolactone combined with isosorbide nitrate in the control group, spironolactone combined with captopril tablets and isosorbide mononitrate in the experimental group.The clinical efficacy, left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),hypersensitive C-reactive protein(hs-CRP),B type natriuretic peptide(BNP),arterial partial pressure of oxygen(PaO_(2)),partial pressure of arterial carbon dioxide(PaCO_(2)),blood oxygen saturation(SpO_(2)),forced vital capacity(FVC),and forced expiratory volume in first second(FEV1) and FEV1/FVC levels were compared between the two groups.Results:The total effective rate of the experimental group was higher than that of the control group(P<0.05).The levels of LVEDD,HS-CRP,BNP and PaCO_(2)in the experimental group were lower than those in the control group(P<0.05).The levels of LVEF,PaO_(2),SpO_(2),FVC,FEV1 and FEV1/FV in the experimental group were higher than those in the control group(P<0.05).Conclusion:Spironolactone combined with captopril tablets and isosorbide mononitrate can effectively improve cardiopulmonary function and blood gas indexes in patients with severe COPD and cor pulmonale.

关 键 词：重度慢性阻塞性肺疾病 肺心病 螺内酯 卡托普利片 单硝酸异山梨酯 心功能 血气水平 

分 类 号：R563.9[医药卫生—呼吸系统] R541.5[医药卫生—内科学]