RESUMO
Objective :To explore therapeutic effect of spironolactone on aged patients with coronary heart disease (CHD) complicated chronic congestive heart failure (CHF ) and its influence on level of brain natriuretic peptide (BNP) and cardiac function .Methods : A total of 96 aged CHD + CHF patients treated in our hospital were ran-domly and equally divided into routine treatment group and spironolactone group ,both groups were treated for three months.Therapeutic effect ,plasma BNP level and cardiac function before and after treatment were observed and compared between two groups .Results : After three-month treatment ,total effective rate of spironolactone group was significantly higher than that of routine treatment group (95-8% vs.72-9%,P＝0-002).Compare with before treatment , there were significant reductions in plasma BNP level and left ventricular end-diastolic dimension (LVEDd) ,and significant rise in left ventricular ejection fraction (LVEF) in two groups after three-month treat-ment , P＜ 0-01 all ;compared with routine treatment group after treatment ,there were significant reductions in plasma BNP level [ (440-11 ± 76-90) ng／L vs.(359-21 ± 51-21 ) ng／L ] and LVEDd [ (62-91 ± 3-90 ) mm vs. (59-12 ± 2-38) mm] ,and significant rise in LVEF [ (43-23 ± 5-80)% vs.(49-46 ± 5-98)%] in spironolactone group , P＝0-001 all .Incidence rate of complications in spironolactone group was significantly lower than that of routine treatment group (8-3% vs.22-9%, P＝0-049).Conclusion : Spironolactone possesses significant therapeu-tic effect on aged CHD + CHF patients .It can significantly reduce plasma BNP level and improve cardiac function , which is worth extending .