螺内酯治疗对轻度心力衰竭患者骨桥蛋白水平的影响

本研究选取2013年1月～2013年8月广东省韶关市铁路医院收治的轻度心力衰竭（左室射血分数〈40％，NYHAⅡ级）患者共65例，随机分为试验组（A组）和对照组（B组），A组在常规基础治疗之上加用螺内酯（20rag、Qd），B组采用常规基础治疗。于患者住院期间及出院后3个月抽血行EI。IsA法检测血清骨桥蛋白、NT—proBNP水平以及心脏超声检查测量左室舒张末内径（LVEDd）以及左室射血分数（LVEF）。结果显示：两组患者在年龄、性别、低密度脂蛋白等比较，差异无统计学意义（P〉0．05）。与治疗前比，治疗后两组患者血清骨桥蛋白、NT-proBNP水平、LVEDd均明显下降，差异均具有统计学意义（P〈0．05），但试验组血清骨桥蛋白、NT—proBNP水平下降更明显，两组相比差异均具有统计学意义（P〈0．05）。治疗后，两组患者的LVEF均高于治疗前，但差异均无统计学意义（P〉0．05）。直线相关分析显示：血清骨桥蛋白水平与NT-proBNP水平呈正相关（r=0．235，P〈0．05），与LVEDd呈正相关（r=0．432，P〈0．05）。提示在常规基础治疗上加用螺内酯可以改善轻度心力衰竭患者心室重构及骨桥蛋白的水平。

Effects of Spirolactone on the Change of Serum Osteopontin in Chronic Heart Failure Patients with Mild Symptoms

We collected 65 patients with heart failure （LVEF〈40%, NYHA class Ⅱ ） in our hospital from January 2013 to August 2013. They were divided into experimental group （Group A） and control group （Group B）. Patients in Group A were treated with spirolactone on the basis of routine treatment. Patients in Group B were treated with routine treatment. The levels of serum H-FABP and NT-proBNP were detected by enzyme-linked immunosorbent assay （ELISA）, as well as LVEDd and LVEF were measured by Echocardiograpby when patients were in hospital and three months after discharge. There were no significant differences of clinical characteristics between two groups, such as age, gender composition, low density lipoprotein cholesterol （P〉0. 05）. After treatment, the level of serum osteopontin and NT-proBNP as well as LVEDd were obvious decreased, and the differences were statistically significant （P〈0.05）. The differences of the levels of serum osteopontin and NT-proBNP after treatment in Group A were much greater than Group B. When compared with the differences of the levels of them between two groups, the differences were statistically significant （P〈0.05）. After treatment, LVEF were increased in two groups, but the differences showed no statistically significant （P〉0.05）. Linear rank correlation analysis showed that there were positive correlations between level of serum osteopontin and level of serum NT-proBNP, LVEDd （r=0. 235, 0. 432 respectively, P〈0.05）. These result suggest that after treated with spirolactone on the basis of routine treatment, ventricle remodeling and the levels of serum osteopontin in chronic heart failure patients with mild symptoms can be improved.