摘要
目的探讨螺内酯对维持性血液透析患者心脏结构改善及安全性的影响。方法选取2017年6月至2019年6月南昌市第一医院收治的109例终末期肾脏病(ESRD)患者作为研究对象,随机分为螺内酯组(n=54)和安慰剂组(n=55)。两组均采取维持性血液透析治疗。螺内酯组给予小剂量螺内酯,安慰剂组给予淀粉片。比较两组治疗前后左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心房内径(LAD)、左心室射血分数(LVEF)及并发症发生情况。结果治疗前,两组LVESD、LVEDD、LAD、LVEF比较差异无统计学意义;治疗后,螺内酯组LVESD、LVEDD、LAD均短于治疗前,LVEF高于治疗前,且螺内酯组LVESD、LVEDD、LAD均短于安慰剂组,LVEF高于安慰剂组,差异有统计学意义(P<0.05);安慰剂组治疗前后LVESD、LVEDD、LAD、LVEF比较差异无统计学意义。螺内酯组并发症发生率为37.25%,低于安慰剂组的58.49%,差异有统计学意义(P<0.05)。结论血液透析治疗过程中给予小剂量螺内酯可改善患者心功能,减少并发症发生风险,改善ESRD预后,值得临床推广应用。
Objective To investigate the effect of spironolactone on cardiac structure improvement and safety in maintenance hemodialysis patients.Methods 109 patients with end-stage renal disease(ESRD)admitted to the First Hospital of Nanchang City from June 2017 to June 2019 were selected as the research subjects and they were randomly divided into spironolactone group(n=54)and placebo group(n=55).Both groups were treated with maintenance hemodialysis.The spironolactone group was given low-dose spironolactone,and the placebo group was given starch tablets.The left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD)and left ventricular ejection fraction(LVEF),before and after treatment and the incidence of complications were compared between the two groups.Results Before treatment,there were no significant differences in LVESD,LVEDD,LAD and LVEF between the two groups;after treatment,LVESD,LVEDD and LAD in the spironolactone group were shorter than those before treatment,and LVEF was higher than that before treatment,and LVESD,LVEDD and LAD in the spironolactone group were shorter than those in the placebo group,and LVEF was higher than that in the placebo group,the differences were statistically significant(P<0.05);there was no significant difference in LVESD,LVEDD,LAD and LVEF before and after treatment in the placebo group.The incidence of complications in the spironolactone group was 37.25%,which was lower than 58.49%in the placebo group,and the difference was statistically significant(P<0.05).Conclusion Low-dose spironolactone during hemodialysis treatment can improve cardiac function,reduce the risk of complications,and improve the prognosis of ESRD,which is worthy of clinical promotion and application.
作者
卜珊珊
蒋智敏
王仁勇
徐乐
BU Shanshan;JIANG Zhimin;WANG Renyong;XU Le(Department of Nephropathy,The First Hospital of Nanchang,Nanchang,Jiangxi,330008,China)
出处
《当代医学》
2022年第36期64-67,共4页
Contemporary Medicine
基金
江西省卫生厅科技计划(20167020)。
关键词
螺内酯
血液透析
心脏结构
Spironolactone
Hemodialysis
Cardiac structure
