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[螺内酯治疗心性水肿九年的长期疗效]

[Long term therapy over nine years with Spironolacton in hydropic cardiac insufficiency].

作者信息

Ehrlich U, Klepzig H

出版信息

Med Klin. 1976 Sep 17;71(38):1546-54.

PMID:135920
Abstract

The effect of the aldosterone-antagonist Spironolacton in decompensated hydropic cardiac insufficiency is explored with patients not re-compensated under a glycosid-diuretica-therapy. This analysis is based on the clinical records and other documents of 34 patients with most serious oedematous cardiac insufficiency of different genesis. For elucidation of the result of the clinical treatment two casuistic cases are described. The probability of mortality or survival-rate is calculated, periods of observation could be achieved up to more than nine years. It is endeavoured to compare the results with observations of patients-collectives, that are known from the literature. Statistically significant decreases in weight are objectified. When examining the reactions of blood-pressure at the Spironolacton-therapy no statistically significant alterations of blood-pressure could be observed with those cardiac-decompensated patients. 6.25 per cent of the considered serum-potassium-data were underneath the limitations of lower standard, at 1.875 per cent of the measured values a hyperkalemia existed. No clinical side-effects could be observed except the incidence of a gynaecomastia with two male patients. A protracted therapy with Spironolacton for patients with decompensated hydropical myocardial insufficiency is appropriated to support recompensation in addition to the hitherto conventional possibilities of therapy, and to maintain this achieved re-compensation.

摘要

在接受糖苷利尿剂治疗后仍未得到代偿的患者中,研究了醛固酮拮抗剂螺内酯对失代偿性水肿性心功能不全的影响。该分析基于34例不同病因的最严重水肿性心功能不全患者的临床记录和其他文件。为阐明临床治疗结果,描述了两个病例。计算了死亡率或生存率的概率,观察期可达九年以上。努力将结果与文献中已知的患者群体观察结果进行比较。体重下降具有统计学意义。在检查螺内酯治疗时的血压反应时,未观察到失代偿性心力衰竭患者的血压有统计学意义的变化。所考虑的血清钾数据中有6.25%低于较低标准的限值,1.875%的测量值存在高钾血症。除两名男性患者出现乳腺增生外,未观察到临床副作用。对于失代偿性水肿性心肌功能不全患者,除了目前传统的治疗方法外,长期使用螺内酯进行治疗有助于支持代偿,并维持已实现的代偿状态。

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