培哚普利联合螺内酯治疗非腺瘤型原发性醛固酮增多症的临床疗效研究

目的:研究培哚普利联合螺内酯治疗非腺瘤型原发性醛固酮增多症患者的临床效果及安全性。方法:选取在我院进行诊治的62例非腺瘤型原发性醛固酮增多症患者并将其随机分为对照组和观察组,每组31例。对照组患者在常规治疗方案的基础上给予20 mg螺内酯口服,一天3次;观察组患者在对照组的基础上加用4 mg培哚普利口服,一天1次。所有患者均治疗3个月,观察和比较两组的临床疗效,治疗前后血压、心功能、血钾、6分钟步行试验结果的变化。结果:(1)治疗后,对照组临床总有效率为74.2%(23/31),较观察组93.5%(29/31)]显著降低(P0.05);(2)治疗后,两组患者收缩压和舒张压、LVESD(左室收缩末期内径)、LVEDD(左室舒张末期内径)均显著低于治疗前(P0.05),而LVEF(左室射血分数)、血清钾浓度、6分钟步行距离均显著高于治疗前(P0.05),且观察组患者收缩压和舒张压、LVEDD、LVESD均明显低于对照组,而LVEF、血清钾浓度、6分钟步行距离均显著高于对照组(P0.05);(3)治疗过程中,对照组患者不良反应发生率为6.5%(2/31),观察组为12.9%(4/31),两组之间比较差异无统计学意义(P0.05)。结论:培哚普利联合螺内酯治疗非腺瘤型原发性醛固酮增多症患者可显著提高其临床疗效,改善患者心功能,并有效降低血压,且安全性高。

A Study on the Clinical Efficacy of Perindopril Combined with Spironolactone in the Treatment of Patients with Non--adenoma Type Primary Aldosterone

ABSTRACT Objective: To study the clinical efficacy and security of perindopril combined with spironolactone in the treatment of patients with non--adenoma type primary aldosterone. Methods: 62 patients with non--adenoma type primary aldosterone in our hospital were selected and randomly divided into the control group and the observation group with 31 cases in each group. The control group was given 20mg spironolactone orally on the basis of conventional treatment, 3 times a day; while the observation group was additionally given 4mg perindopril orally on the basis of control group, 1 times 1 day. All patients were treated for 3 months, the clinical efficacy, and the changes of blood pressure, heart function, blood potassium and the 6 minute walking test before and after treatment were observed and compared two groups. Results: (1)After treatment, the total clinical effective rate of control group was 74.2%(23/31), which was signifi- cantly lower than that of the observation group 93.5%(29/31)](P<0.05); (2) After treatment, the systolic and diastolic blood pressure, LVEDD, LVESD were significantly lower than before treatment(P<0.05), and the LVEE, serum potassium concentration, 6 minute walk- ing test were significantly higher than those before treatment(P<0.05), and the systolic and diastolic blood pressure, LVEDD, LVESD of observation group were significantly lower than those of the control group(P<0.05), and the LVEE, serum potassium concentration, 6 minute walking test were significantly higher than those of the control group(P<0.05); (3)During the treatment, the incidence of adverse reactions in the control group and observation group was 6.5%(2/31) and 12.9%(4/31), no significant difference was found between two groups(P>0.05). Conclusion: Perindopril combined with spironolactone can significantly improve the clinical efficacy in the treatment of patients with non-adenoma type primary aldosterone, it improve the heart function of patients, and effectively reduce blood pressure with high safety.