CAJ | 학술논문

目的：评价小剂量螺内酯治疗高龄肺心病慢性心功能不全疗效及安全性。方法选择56例高龄肺心病合并慢性心功能不全患者，随机分为治疗组（26例），对照组（30例），两组均给予常规治疗，治疗组给予螺内酯20mg，每日1次，平均服用半年。两组患者随访结束时检测肺动脉压及血浆B型脑钠肽前体（pro-BNP）反应疗效指标；检测血清钾、尿酸、肌酐、尿素氮水平及观察乳房发育、乳腺疼痛等副反应指标。结果治疗组肺动脉压及pro-BNP均较对照组降低，差异有统计学意义（P ＜0.01），而两组中血清钾、尿酸、肌酐、尿素氮比较差异无统计学意义（P＞0.05），所有患者中均未发现有乳房发育、乳腺疼痛发生。结论小剂量螺内酯治疗高龄肺心病慢性心功能不全有效且安全。
목적：평개소제량라내지치료고령폐심병만성심공능불전료효급안전성。방법선택56례고령폐심병합병만성심공능불전환자，수궤분위치료조（26례），대조조（30례），량조균급여상규치료，치료조급여라내지20mg，매일1차，평균복용반년。량조환자수방결속시검측폐동맥압급혈장B형뇌납태전체（pro-BNP）반응료효지표；검측혈청갑、뇨산、기항、뇨소담수평급관찰유방발육、유선동통등부반응지표。결과치료조폐동맥압급pro-BNP균교대조조강저，차이유통계학의의（P ＜0.01），이량조중혈청갑、뇨산、기항、뇨소담비교차이무통계학의의（P＞0.05），소유환자중균미발현유유방발육、유선동통발생。결론소제량라내지치료고령폐심병만성심공능불전유효차안전。
Objective To investigate the efficacy and safety of lower doses spironolactone in advanced age patients with the chronic heart failure of pulmonary heart disease. Methods Fifty six patients with the chronic heart failure of pulmonary heart disease were randomly divided into treatment group (n=26) and control group(n=30). Both groups were given routine treatment and spironolactone was administered to patients 20mg bid in treatment group for about six months. Clinical effects were assessed by detecting pulmonary artery pressure, plasma pro-BNP. Safety were assessed by detecting the level of serum potassium, uric acid, creatinine, blood urea nitrogen and observing the chance of gynecomastia, breast pain. Results About pulmonary artery pressure and plasma pro-BNP, treatment group is obviously lower than control group (P < 0.01), with statistical significance; Meanwhile, there were no significant differences in serum potassium, uric acid, creatinine, blood urea nitrogen level(P>0.05). All patients were not found gynecomastia and breast pain. Conclusion It is effective and safe for advanced age patients with the chronic heart failure of pulmonary heart disease in lower doses of spironolactone.