观察小剂量螺内酯辅助治疗高龄冠心病(CAD)合并慢性心力衰竭(CHF)的临床效果。

将2016年9月至2017年6月郸城县人民医院收治的84例CAD合并CHF患者纳入研究，按照随机数表法将其分为A、B两组，各42例。A组患者接受常规治疗，B组患者在常规治疗的基础上接受小剂量螺内酯辅助治疗。比较两组患者治疗总有效率，治疗前后LVEF、NT－proBNP水平，不良反应发生率。

B组患者治疗总有效率(95.24%)高于A组(78.57%)，差异有统计学意义(P<0.05)。B组患者治疗后LVEF水平高于A组(P<0.05)，NT－proBNP水平低于A组(P<0.05)。A组不良反应发生率为9.52%，B组不良反应发生率为11.90%，组间差异无统计学意义(P>0.05)。

小剂量螺内酯辅助治疗CAD合并CHF临床效果较好，可有效改善患者心功能，且小剂量用药不会增加用药风险，可在临床推广。

To observe the clinical efficacy of low-dose spironolactone in the treatment of advanced coronary heart disease (CAD) with chronic heart failure (CHF).

A total of 84 patients with CAD and CHF admitted to Dancheng People's Hospital from September of 2016 to June of 2017 were included in the study. They were divided into two groups according to the random number table method, 42 cases in each group. Patients in group A received routine treatment, while patients in group B received low-dose spironolactone adjuvant therapy on the basis of routine treatment. The total effective rate, the level of LVEF, NT-proBNP before and after treatment and the incidence of adverse reactions were compared between the two groups.

The total effective rate of group A was 78.57% and that of group B was 95.24%. The total effective rate of group B was higher than that of group A, and the difference was statistically significant (P<0.05). After treatment, the level of LVEF in group B was higher than that in group A (P<0.05), and the level of NT-proBNP was lower than that in group A (P<0.05). The incidence of adverse reactions was 9.52% in group A and 11.90% in group B. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Low-dose spironolactone has a good clinical efficacy in the adjuvant treatment of CAD combined with CHF, which can effectively improve the cardiac function of patients, and does not increase the risk of drug use, so it can be popularized in clinic.