| Objective: To investigate the effects of target dose spironolactone(20mg/d) combined with trimetazidine on inflammatory factors, renin angiotensin aldosterone system (RAAS) and heart rate variability in elderly patients with chronic heart failure (CHF). Methods: 120 elderly patients with CHF were selected, and randomly divided into control group and study group by simple randomization, 60 cases in each group. The control group was treated with trimetazidine, and the study group was treated with trimetazidine combined with target dose of spironolactone. The curative effect, inflammatory factors [high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor - α (TNF - α), interleukin-6 (IL-6)], RAAS indexes [renin (PRA), angiotensin Ⅱ (Ang Ⅱ) and aldosterone (ALD)], heart rate variability[24h mean standard deviation of normal R-R interval (SDNN), 24h continuous 5min segment mean standard deviation of normal R-R interval (SDANN), root mean square of continuous normal R-R interval difference (rMSSD)], cardiac function [left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD)] and safety of the two groups were compared. Results: Compared with the control group, the total effective rate of the study group was higher (P<0.05). 6 months after treatment, hs-CRP, TNF-α, IL-6, LVESD, LVEDD, PRA, Ang Ⅱand ALD of the two groups were lower than those before treatment, and the above indexes of the study group were lower than the control group (P<0.05). 6 months after treatment, LVEF of the two groups was higher than that before treatment, and the LVEF of the study group was higher than the control group (P<0.05). 6 months after treatment, SDNN, SDANN and rMSSD of the study group were higher than those before treatment, and the above indexes of the study group were higher than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: The trimetazidine combined with target dose of spironolactone in the treatment of elderly patients with CHF has remarkable curative effect and the safety is good, it can significantly improve the cardiac function and heart rate variability of patients, reduce the level of inflammatory factors, which may play a role by antagonizing RAAS. |
