摘要
目的 :观察螺内酯和血管紧张肽Ⅱ转化酶抑制药 (ACEI)长期联用治疗心力衰竭的疗效及安全性。方法 :12例患者治疗前先使用地高辛和排钾利尿药 ,入选后加用螺内酯和ACEI。螺内酯使用剂量 2 0～ 60mg ,均早晨 1次顿服。ACEI使用 :依那普利 2例 ,福辛普利 3例 ,培哚普利 7例 ,随访 2～ 6a。结果 :心功能 3级 3例均恢复为 2级 ,心功能 4级 5例改善至 3级 ,1例恢复至 2级 ,3例心功能达到 1级。X线胸片显示 4例心胸比率减小。随访检测血清钾 4.0 3～5 .0 1mmol·L 1 ,平均 (4 .60± 0 .3 2 )mmol·L 1 。螺内酯治疗剂量 60mg·d 1 ,2例多次发生腹泻 ,剂量减少后腹泻即停止 ,1例男患者出现乳房增大。结论 :螺内酯和ACEI长期联用治疗心力衰竭是有效的 ,只要用药恰当仍然安全。
Objective:To investigate long-term effect and safety of treatment with spironolactone and ACEI for patients with heart failure. Methods:12 patients who had been administrated with digoxin and urinative before the trial were added with spironolactone and ACEI. Doses of spironolactone were 20～60 mg·d -1. The use of ACEI: 2 patients with enalapril, 3 patients fosinopril and 7 patients perindopril. The patients were followed up for 2 to 6 years. Results:The function of heart of 3 patients recovered from NYHA grade-3 to grade-2, 5 patients from grade-4 to grade-3(4 cases) and to grade-2(1 cases), 3 patients reached grade-1. The ratio of heart and chest in 4 patients were decreased. The serum potassium of 12 patients was 4.03～5.01 mmol·L -1 with an average of (4.60±0.32) mmol·L -1, 2 patients suffered from diarrhea, 1 male patient had breast growth in the observation. Conclusion:The long-term combined treatment with spironolactone and ACEI for patients with heart failure is effective and safe, if the method of therapy is reasonable.
出处
《医药导报》
CAS
2004年第1期19-20,共2页
Herald of Medicine
