螺内酯联合呋塞米治疗慢性肺心病急性发作的临床研究  

Clinical study on the combination of spironolactone and furosemide in the treatment of patients with chronic pulmonary heart disease in exacerbation stage

作　　者：魏秋瑾 李荣辉 WEI Qiujin;LI Ronghui(Zhaoling District People's Hospital of Luohe;The Sixth People's Hospital of Luohe,Luohe 462000,Henan)

机构地区：[1]漯河市召陵区人民医院 [2]漯河市第六人民医院,河南漯河462000

出　　处：《菏泽医学专科学校学报》2024年第4期28-32,共5页Journal of Heze Medical College

摘　　要：目的探究螺内酯与呋塞米联合治疗慢性肺心病(CPHD)急性发作患者的临床疗效。方法选取我院收治的CPHD急性发作患者60例,依据治疗方案不同分为对照组和观察组,每组30例。对照组在常规治疗下予以呋塞米治疗,观察组在对照组的基础上增加螺内酯治疗,两组均治疗7 d。比较两组临床疗效、治疗前后心功能指标[左心室射血分数(LVEF)、每搏量(SV)、心脏指数(CI)、心输出量(CO)]、肺功能指标[用力肺活量(FVC)、第1秒用力呼吸量(FEV1)、第1秒用力呼吸量/用力肺活量(FEV1/FVC)]、血气分析指标[动脉氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))]、血清细胞因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、热休克蛋白27(HSP27)、生长分化因子-15(GDF-15)]水平。结果两组临床疗效比较,P<0.05。治疗后观察组LVEF、SV、CI、CO水平高于对照组(P<0.05);FVC、FEV1、FEV1/FVC水平高于对照组(P<0.05);PaO_(2)、SaO_(2)水平高于对照组,PaCO_(2)水平低于对照组(P<0.05);血清TNF-α、IL-6、HSP27、GDF-15水平低于对照组(P<0.05)。结论螺内酯与呋塞米联合治疗CPHD疗效确切,能减轻炎症反应,减少心肌损伤,改善心功能、肺功能、血气分析指标。Objective To retrospectively explore the clinical efficacy of the combination of spironolactone and furosemide in the treatment of patients with chronic pulmonary heart disease(CPHD)in exacerbation stage.Methods 60 patients with CPHD in exacerbation stage in our hospital were selected and divided into two groups according to the treatment methods,30 cases in each group.The control group was treated with furosemide under the conventional treatment,and the observation group was treated with spironolactone on the basis of control group.Both groups were treated for 7 days.The clinical efficacy,cardiac function indicators before and after treatment[left ventricular ejection fraction(LVEF),stroke volume(SV),heart index(CI),cardiac output(CO)],lung function indicators[forced vital capacity(FVC),forced breathing volume at 1 second(FEV1),forced breathing volume/forced vital capacity at 1 second(FEV1/FVC)],blood gas analysis indicators[arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),blood oxygen saturation(SaO_(2))],serum cytokines[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),heat shock protein 27(HSP27),and growth differentiation factor-15(GDF-15)were compared between the two groups.Results The comparison of total clinical effective rate between the two groups were with P<0.05.After treatment,the LVEF,SV,CI,and CO in the observation group were higher than those in the control group(P<0.05);the levels of FVC,FEV1 and FEV1/FVC in the observation group were higher than those in the control group(P<0.05);the levels of PaO_(2) and SaO_(2) in the observation group were higher than those in the control group,while the level of PaCO_(2) was lower than that in the control group(P<0.05);the serum TNF-α,IL-6,HSP27 and GDF-15 levels in the observation group were lower than those of the control group(P<0.05).Conclusion The combination of spironolactone and furosemide has definite therapeutic effect on CPHD,which can reduce inflammation,reduce myocardial injury,improve heart functio

关 键 词：螺内酯 慢性肺心病 呋塞米 急性发作 

分 类 号：R541.5[医药卫生—心血管疾病]