联合使用新型容量驱除药物对难治性心力衰竭治疗疗效的观察  

The effects of new volume-removing drugs on refractory heart failure

作　　者：魏宇淼[1] 杨仕俊[1] 李伟娟[1] 廖玉华[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院心血管病研究所,武汉430022

出　　处：《重庆医学》2015年第22期3043-3044,3047,共3页Chongqing medicine

基　　金：国家自然科学基金资助(30871069;81470483)

摘　　要：目的探讨传统利尿剂联合新型容量驱除剂奈西立肽和托伐普坦治疗难治性心力衰竭(RHF)的疗效。方法选择该院心血管病重症病房RHF患者78例,分为联合容量驱除药物组(CVR组)和传统强化利尿并正性肌力药物治疗组(对照组),观察其心力衰竭症状控制率及平均住院日数的差异,以及住院期间平均尿量和体质量下降等容量驱除指标的差异。结果治疗组89.7%的患者心衰症状控制并出院,优于对照组(71.8%),相应的死亡或放弃治疗率在治疗组显著下降,且平均住院日数较对照组显著缩短(P<0.05);CVR组的NT-proBNP和治疗前后体质量下降均高于对照组,差异有统计学意义(P<0.05)。结论使用联合的容量驱除治疗措施较传统的治疗措施可显著提高RHF的容量驱除和心力衰竭症状控制率。Objective To investigate the effect of diuretics combined with the new class volume-removing drugs nesiritide and tolvaptan on refractory heart failure （RHF）. Methods We collected 78 patients with RHF from cardiovascular ICU in our hos- pital,and patients were divided into combined volume-removing drugs treatment group （CVR group） and traditional diuretics com- bined with inotropie treatment group （control group）. We observed the differences m the heart failure symptoms control rate and the average hospitalization days between the two groups. The difference in average urine volume and weight loss during hospitaliza- tion was observed. Results The heart failure symptoms were controlled and successful discharge in 89. 7% of patients in CVR group,which was better than that in control group（71.8 %）. The corresponding rates of death or abandonment was decreased sig- nificantly in CVR group,and the average number of hospitalization days in CVR group was significantly shorter than that in control group（P〈0.05）. Meanwhile, the average daily urine volume and the weight loss decreased significantly in CVR group than those in control group（P〈0.05）. Conclusion The therapy strategy of combined volume-removing drugs can significantly improve the vol- ume removing and control rate of heart failure symptoms.

关 键 词：心力衰竭 利钠肽 脑 托伐普坦 临床疗效 容量驱除 

分 类 号：R541.6[医药卫生—心血管疾病]