梁俊斌+陈利群+刘婉连

[摘要] 目的 观察螺内酯联合苯那普利治疗高血压性心脏病充血性心力衰竭的临床效果。方法 选择2012年6月～2013年12月本院接诊的80例高血压性心脏病充血性心力衰竭患者，按照随机数字表法分为观察组和对照组，对照组采用苯那普利治疗，观察组在对照组的基础上，采用螺内酯治疗。比较两组的疗效和不良反应发生率，治疗前后心功能相关指标、血压及心率。 结果 两组治疗后的LAD、INS、LVEDD、LVEF及NT-pro-BNP改善均明显优于治疗前，观察组治疗后的LVPW改善优于治疗前，差异有统计学意义（P＜0.01）；观察组治疗后的LAD、INS、LVPW、LVEDD、LVEF及NT-pro-BNP改善均明显优于对照组，差异有统计学意义（P＜0.05）。两组治疗后的收缩压、舒张压及心率均明显低于治疗前，差异有统计学意义（P＜0.01）；观察组治疗后的收缩压、舒张压及心率均明显低于对照组，差异有统计学意义（P＜0.05）。观察组的总有效率为87.50%，明显高于对照组的67.50%，两组比较差异有统计学意义（u=-2.2686，P=0.0233）。两组的不良反应发生率比较差异无统计学意义（χ2=0.6723，P=0.4123）。 结论 螺内酯联合苯那普利治疗高血压性心脏病充血性心力衰竭的效果显著，安全性高，值得临床推广应用。

[关键词] 高血压性心脏病；充血性心力衰竭；螺内酯；苯那普利；疗效

[中图分类号] R541.3[文献标识码] A[文章编号] 1674-4721（2014）05（c）-0094-03

Clinical efficacy observation of spironolactone combined with benazepril in the treatment of hypertensive heart disease and congestive heart failure

LIANG Jun-bin CHEN Li-qun LIU Wan-lian

Department of Emergency,Daojiao Hospital of Dongguan City in Guangdong Province,Dongguan 523176,China

[Abstract] Objective To evaluate the clinical efficacy of spironolactone combined with benazepril in the treatment of hypertensive heart disease and congestive heart failure. Methods 80 cases of patients with hypertensive heart disease and congestive heart failure from June 2012 to December 2013 in our hospital were selected and divided into observation group and control group according to a random number table method.Control group was treated with benazepril,on the basis of control group therapy,observation group was treated with spironolactone.The efficacy,incidence rate of adverse reaction,related index of heart function,blood pressure,heart rate before and after treatment in two groups was compared respectively. Results After treatment,LAD,INS,LVEDD,LVEF,NT-pro-BNP in two groups was better than that before treatment respectively,LVPW in observation group was better than that before treatment,with statistical difference(P＜0.01).After treatment,LAD,INS,LVPW,LVEDD,LVEF,NT-pro-BNP in observation group was better than that in control group,with statistical difference(P＜0.05).The systolic blood pressure,diastolic blood pressure and heart rate in two groups after treatment was significantly lower than that before treatment respectively,with statistical difference(P＜0.01).The systolic blood pressure,diastolic blood pressure and heart rate in observation group after treatment was significantly lower than that in control group respectively,with statistical difference(P＜0.05).Total efficiency rate of observation group was 87.50%,significantly higher than that of control group(67.50%),with statistical difference(u=-2.2686,P=0.0233).Incidence rate of adverse reaction in two groups was compared,with no statistical difference(χ2=0.6723,P=0.4123). Conclusion The clinical efficacy of spironolactone combined with benazepril in the treatment of hypertensive heart disease and congestive heart failure is remarkable and safe,it is worthy of clinical promotion and application.

[Key words] Hypertensive heart disease;Congestive heart failure;Spironolactone;Benazepril;Efficacy

充血性心力衰竭心室的泵血或充盈功能逐渐低下，心排血量不能满足机体代谢的需要，引起肺循环和体循环缺血，是各种心脏病发展到严重阶段的综合征[1-2]。高血压长期控制不佳引起的高血压性心脏病会因为心脏结构的改变而导致心肌收缩功能减退，最终发生充血性心力衰竭。……