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目的观察小剂量螺内酯对重度慢性心力衰竭(CHF)的有效性及安全性。方法将116例重度CHF患者,随机分为治疗组(A组)和对照组(B组),每组58例,两组均给予常规抗心衰治疗。A组联用小剂量螺内酯(20mg/d),两组疗程均为6个月,治疗前、后分别进行心功能(NYHA)评估、6min步行试验、超声心电图及血清脑钠肽(BNP)检测等,并进行分析、对照。结果治疗随访6个月A、B组心功能分级、6min步行距离、LVEF、左心室舒张末期内径(LVEDd)及血清BNP水平较治疗前均显著改善(P<0.05),A组指标变化较B组更明显,两组之间的差异有统计学意义(P<0.05)。结论小剂量螺内酯治疗重度CHF能明显改善患者心功能及远期预后,安全可靠。
Objective To observe the efficacy and safety of low-dose spironolactone in patients with severe chronic heart failure (CHF). Methods A total of 116 patients with severe CHF were randomly divided into treatment group (A group) and control group (B group), 58 cases in each group. Both groups were given conventional anti-heart failure treatment. Group A was treated with low-dose spironolactone (20mg / d) for 6 months. Before and after treatment, NYHA, 6-minute walk test, echocardiography and BNP And so on, and analysis, control. Results At 6 months after treatment, heart function grading, 6-minute walk distance, LVEF, LVEDd and serum BNP level in group A and B were significantly improved compared with those before treatment (P <0.05) Group was more obvious, the difference between the two groups was statistically significant (P <0.05). Conclusion Low-dose spironolactone treatment of severe CHF can significantly improve the patient’s cardiac function and long-term prognosis, safe and reliable.