早期应用小剂量多巴胺联合呋塞米治疗心力衰竭的疗效  

Clinical effect of low dose dopamine combined with furosemide early in the treatment of patients with heart failure

作　　者：都斌[1,2] 姚雪艳[2] 

机构地区：[1]浙江大学医学院附属第一医院心内科,杭州310003 [2]仙居县人民医院心内科,浙江仙居317300

出　　处：《中国临床药理学杂志》2013年第3期163-165,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察早期应用小剂量多巴胺联合呋塞米治疗心功能Ⅲ～Ⅳ级心力衰竭的有效性及安全性。方法入选美国纽约心脏病学会心功能分级Ⅲ～Ⅳ级的患者124例,随机分为2组:联合治疗组和呋塞米组(均62例)。呋塞米组,仅静脉注射呋塞米(20～40 mg.d-1);联合治疗组,除静脉注射相同剂量呋塞米外还静脉持续泵入小剂量多巴胺(0.5～1.0μg.kg-1.min-1)。观察2组治疗前后血清钾与钠、血压、心率、体重、左室射血分数(LVEF)、B型尿钠肽(BNP)的变化及住院天数和肾功能恶化程度,并判断疗效。结果联合治疗组与呋塞米组,平均住院天数分别为(5.75±1.30),(8.12±1.10)d(P=0.025)。出现利尿剂抵抗和肾功能恶化的患者,联合治疗组均显著低于呋塞米组;体重、BNP的下降与LVEF升高,联合治疗组较对照差异均有统计学意义(均P<0.05)。联合治疗组的总有效率明显优于呋塞米组(95.2%vs 77.42%,P<0.05)。仅呋塞米组死亡1例。结论早期应用小剂量多巴胺联合呋塞米对心功能Ⅲ～Ⅳ级心力衰竭患者的疗效优于单独用呋塞米。Objective To observe the clinical efficacy of early low dose of dopamine combined with furosemide in treatment of patients with heart failure.Methods A total of 124 patients with Newyork Heart Association（NYHA） class III or class IV were enrolled and were randomized into two groups（both,n=62）：combining dopamine group,were given low dose of dopamine（0.5~1.0 μg·kg-1·min-1） combined with intravenous furosemide（20~40 mg·d-1）;furosemide group,received furosemide（20~40 mg·d-1）.The days of hospitalization,diuretic resistance,deterioration of renal function,death,potassium and sodium of serum,blood pressure,heart rate,weight loss,left ventricular ejection fraction（LVEF） values,B-type natriuretic peptide（BNP） composition were observed.Results Days of hospitalization were（5.75±1.30）,（8.12±1.10） days（P=0.025） in the dopamine group and furosemide group,respectively.Weight loss,BNP decreased and LVEF rised in conbination group significantly compared with the furosemide group（all P0.05）.Total effecte rate was 95.2%,77.42% in conbination group and furosemide group,respectively（P0.05）.One patient died only in the furosemide group.Conclusion Early low dose dopamine combined with furosemide usagee in patients with heart failure is more effective than single use of furosemide.

关 键 词：心力衰竭 呋塞米 多巴胺联用呋塞米 

分 类 号：R983.1[医药卫生—药品] R541.6[医药卫生—药学]