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目的:观察螺内酯对慢性心力衰竭(CHF)患者心脏自主神经功能的影响。方法:回顾性收集某院2012年12月-2014年12月收治的CHF患者52例,按照给药方案的不同分为观察组和对照组。对照组26例采取基础抗心衰方案治疗;观察组26例在基础抗心衰治疗上加用螺内酯(20 mg·d-1),治疗前1天及治疗后16周行动态超声心动图检查,通过系统分析得出心率变异性(HRV)的时域及频域分析指标。结果:与对照组比较,螺内酯治疗16周后HRV明显改善(t=13.406,P<0.05);时域指标:全部窦性R-R间期的标准差(SDNN)、全部窦性R-R间期差值的均方根(rMSSD)、每5分钟窦性R-R平均值的标准差(SDANN)、SDNN的均值(SDNNI)均明显升高(t=5.829,10.256,6.005,7.128,P<0.05);频域指标:低频(LF)、高频(HF)也明显提高(t=9.231,7.441,P<0.05)。结论:螺内酯可明显改善CHF患者的HRV,改善心脏自主神经功能。
Objective: To observe the effects of spironolactone on cardiac autonomic nervous system in patients with chronic heart failure (CHF). Methods: A retrospective collection of 52 cases of CHF patients admitted from December 2012 to December 2014 in a hospital was divided into observation group and control group according to different dosage regimen. 26 cases in the control group were treated with basic anti-heart failure regimen; 26 cases in the observation group were treated with spironolactone (20 mg · d-1) on the basis of anti-heart failure treatment, dynamic echocardiography was performed on the day before treatment and 16 weeks after treatment , Through the system analysis of heart rate variability (HRV) in the time domain and frequency domain analysis of indicators. Results: Compared with the control group, HRV significantly improved after 16 weeks of spironolactone treatment (t = 13.406, P <0.05); time domain index: standard deviation of all sinus RR interval (SDNN), total sinus RR interval difference (RMSSD). The standard deviation (SDANN) and the mean SDNNI (SDNNI) of sinus rhythm averaged every 5 minutes were significantly higher (t = 5.829,10.256,6.005,7.128, P <0.05) Domain indicators: low frequency (LF), high frequency (HF) also significantly increased (t = 9.231,7.441, P <0.05). Conclusion: Spironolactone can significantly improve HRV in CHF patients and improve cardiac autonomic function.