小剂量螺内酯片和呋塞米片联合应用于左心室衰竭患者中的效果林晓亮① 黄巧智① 【摘要】 目的：观察小剂量螺内酯片和呋塞米片联合应用于左心室衰竭患者中的效果。
方法：选择2020年1月—2022年 1月广东省湛江农垦第二医院收治的左心室衰竭患者86例，以随机数表法将其分为两组，各43例。
两组均接受常规治疗，在此基础上，对照组联合使用呋塞米片；研究组在对照组基础上联合小剂量螺内酯片，两组均治疗8周。
比较两组治疗前后血清指标、6 min步行试验及超声指标，评价治疗效果，并统计治疗过程中药物不良反应及并发症的发生率。
结果：治疗后，两组N末端B型利尿钠肽原（NT-proBNP）、磷酸肌酸同工酶（CK-MB）、左室收缩末直径（LVESD）、左室舒张末直径（LVEDD）均较治疗前下降，研究组均低于对照组，差异均有统计学意义（P<0.05）；治疗后，两组步行6 min的距离（6MWT）、左室射血分数（LVEF）、心排出量（CO）均较治疗前升高，研究组均高于对照组，差异均有统计学意义（P<0.05）。
研究组治疗总有效率为97.67%，高于对照组的81.40%，差异有统计学意义（P<0.05）。
治疗过程中，研究组药物不良反应发生率为4.66%，低于对照组的20.93%，差异有统计学意义（P<0.05）；研究组并发症发生为2.33%，稍低于对照组的9.30%，但两组比较，差异无统计学意义（P>0.05）。
结论：在左心室衰竭患者的治疗中，实施以小剂量螺内酯片和呋塞米片联合应用的治疗方案，相对于单一呋塞米治疗，更能显著改善患者心脏功能指标，减轻心室衰竭程度，提升治疗效果，并相对减少单一用药的不良反应，效果理想，可作为临床在治疗左心室衰竭患者的治疗方案。
【关键词】 小剂量 螺内酯片 呋塞米片 联合治疗 左心室衰竭 doi：10.14033/ki.cfmr.2023.11.016 文献标识码 B 文章编号 1674-6805（2023）11-0061-04 Effect of Low-dose Spironolactone Tablets Combined with Furosemide Tablets in Patients with Left Ventricular Failure/ LIN Xiaoliang, HUANG Qiaozhi. //Chinese and Foreign Medical Research, 2023, 21(11): 61-64 [Abstract] Objective: To observe the effect of low-dose Spironolactone Tablets combined with Furosemide Tablets in patients with left ventricular failure. Method: A total of 86 patients with left ventricular failure admitted to Zhanjiang Agricultural Reclamation Second Hospital in Guangdong Province from January 2020 to January 2022 were selected and divided into two groups with 43 cases in each group by random number table method. Both groups received conventional treatment, on this basis, the control group was combined with Furosemide Tablets; the study group was combined with low-dose Spironolactone Tablets on the basis of the control group, and both groups were treated for 8 weeks. Serum indexes, 6-min walking test and ultrasound indexes were compared between the two groups before and after treatment, the therapeutic effect was evaluated, the incidence of adverse drug reactions and complications in the course of treatment was analyzed. Result: After treatment, N-terminal pro-brain B-type natriuretic peptides (NT-proBNP), creatine kinase isoenzymes (CK-MB), left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter (LVEDD) in both groups were decreased compared with before treatment, and the study group were lower than those of the control group, the differences were statistically significant (P<0.05). After treatment, 6 min walking distance (6MWT), left ventricular ejection fraction (LVEF) and cardiac output (CO) in two groups were higher than those of before treatment, and the study group were higher than those of the control group, the differences were statistically significant (P<0.05). The total effective rate of the study group was 97.67%, higher than 81.40% of the control group, the difference was statistically significant (P<0.05). During the treatment, the incidence of adverse drug reactions in the study group was 4.66%, lower than 20.93% in the control group, the difference was statistically significant (P<0.05). The incidence of complications in the study group was 2.33%, slightly lower than 9.30% in the control group, but there was no statistical significance between the two groups (P>0.05). Conclusion: In the treatment of patients with left ventricular failure, the combination of low-dose Spironolactone Tablets and Furosemide Tablets can significantly improve the cardiac function indicators of patients, reduce the degree of ventricular failure, improve the therapeutic effect, and relatively reduce the adverse reactions of single drug. The effect is ideal, which can be used as a clinical treatment plan for patients with left ventricular failure. [Key words] Low-dose Spironolactone Tablets Furosemide Tablets Combined therapy Left ventricular failure First-author's address: Zhanjiang Agricultural Reclamation Second Hospital in Guangdong Province, Zhanjiang 524272, China①广东省湛江农垦第二医院 广东 湛江 524272 急性心力衰竭是由于突然发生心脏结构和功能的异常，导致短期内心排血量急剧降低，组织器官灌注不足和静脉急性淤血，不能满足全身组织器官代谢需要的一种病理状态[1]。
