Zhang Yuan, Li Yanming, Cheng Guanchang
Department of Cardiology, Henan University Huaihe Hospital, Kaifeng, Henan 475000, P.R. China.
Exp Ther Med. 2015 Dec;10(6):2345-2350. doi: 10.3892/etm.2015.2837. Epub 2015 Oct 30.
The aim of the present study was to investigate the effect of low-dose diuretics on the serum cystatin C (CysC) and serum creatinine (Scr) levels, and on the prognosis in patients with asymptomatic chronic heart failure (HF). A total of 66 asymptomatic chronic HF patients were divided into the observation and control groups (n=33 in each group). Patients in the control group were treated with a routine treatment, while the patients in the observation group were treated with the diuretic hydrochlorothiazide along with the same routine treatment as the control group. The left ventricular ejection fraction (LVEF), serum CysC levels, Scr levels, heart function, prognosis, adverse reactions and complications of the patients in the two groups were compared prior to and following treatment. The LVEF increased in the two groups following treatment, while the levels of serum CysC and Scr decreased. The LVEF in the observation group increased following treatment for 1, 3 and 6 months compared with the LVEF values in the control group. In addition, the levels of serum CysC and Scr in the observation group were found to be lower compared with those in the control group (P<0.05). The incidence of adverse prognosis following treatment for 6 months in the observation group was lower compared with that in the control group (P<0.05). The proportion of HF patients with New York Heart Association (NYHA) class I and II increased following treatment for 6 months in the two groups (P<0.05). However, in the observation group, a higher number of patients exhibited class I and II disease after treatment for 6 months compared with the number in the control group (P<0.05). Furthermore, no statistically significant difference was observed between adverse reactions and complications in the two groups (P>0.05). In conclusion, low-dose diuretics may effectively improve the cardiac and renal functions and prognosis in asymptomatic chronic HF patients, without increasing the incidence of side effects.
本研究的目的是探讨低剂量利尿剂对无症状慢性心力衰竭(HF)患者血清胱抑素C(CysC)和血清肌酐(Scr)水平以及预后的影响。总共66例无症状慢性HF患者被分为观察组和对照组(每组n = 33)。对照组患者接受常规治疗,而观察组患者在接受与对照组相同的常规治疗的同时,加用利尿剂氢氯噻嗪进行治疗。比较两组患者治疗前后的左心室射血分数(LVEF)、血清CysC水平、Scr水平、心功能、预后、不良反应及并发症。两组患者治疗后LVEF均升高,血清CysC和Scr水平均降低。与对照组相比,观察组治疗1、3和6个月后的LVEF升高。此外,发现观察组的血清CysC和Scr水平低于对照组(P<0.05)。观察组治疗6个月后的不良预后发生率低于对照组(P<0.05)。两组治疗6个月后纽约心脏协会(NYHA)I级和II级HF患者的比例均增加(P<0.05)。然而,与对照组相比,观察组治疗6个月后表现为I级和II级疾病的患者数量更多(P<0.05)。此外,两组的不良反应和并发症之间未观察到统计学上的显著差异(P>0.05)。总之,低剂量利尿剂可有效改善无症状慢性HF患者的心脏和肾功能及预后,而不增加副作用的发生率。