硝普钠与多巴胺联用治疗难治性心衰患者的临床疗效  

Clinical efficacy of sodium nitroprusside combined with dopamine in the treatment of patients with refractory heart failure

作　　者：杨涛[1] 杨露[1] 海峰[1] 谢鑫[2] 

机构地区：[1]大连市第三人民医院重症医学科,辽宁大连116033 [2]辽宁中医药大学,辽宁大连116600

出　　处：《西部医学》2017年第12期1676-1679,共4页Medical Journal of West China

基　　金：辽宁省教育厅科研项目(L2011164)

摘　　要：目的探讨硝普钠与多巴胺联合应用治疗难治性心衰患者的临床效果。方法选取2014年6月至2016年7月大连市三院收治的难治性心衰患者92例,按照简单随机法分为观察组和对照组各46例,对照组给予常规治疗,观察组在此基础上加用硝普钠与多巴胺联合治疗,对比两组治疗总有效率,治疗前后心率(HR)、平均动脉压(MAP)、呼吸频率,左室射血分数(LVEF)、心胸比值、N端脑钠肽前体(NT-proBNP)检测结果,比较两组6min步行实验(6MWT)及血清肌酐(Scr)、尿素氮(BUN)、血尿酸(UA)及不良反应。结果观察组治疗有效率明显高于对照组(P<0.05);治疗后观察组HR及呼吸频率均较对照组降低(P<0.05);治疗后观察组LVEF高于对照组(P<0.05),CTR、NT-proBNP低于对照组(各P<0.05);治疗后观察组6MWT高于对照组(P<0.05),Scr、BUN、UA均较对照组降低(各P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论硝普钠联合多巴胺治疗难治性心衰患者可改善心肾功能及相关实验室常规指标,临床疗效好,不良反应少,可在临床推广应用。Objective To investigate the clinical efficacy of combined use of sodium nitroprusside and dopamine in the treatment of refractory heart failure. Methods From June 2014 to July 2016, 92 patients with refractory heart failure were randomly divided into the observation group and the control group with 46 cases in each group. The control group was given routine treatment, while the observation group was additionally treated with sodium nitroprusside and dopa- mine. The total effective rate was compared between the groups. The heart rate （HR）, mean arterial pressure （MAP）, respiratory rate, left ventricular ejection fraction （LVEF）, cardiothoracic ratio （CTR） and N-terminal pro-brain natri- uretic peptide （NT-proBNP） were used to evaluate the cardiac function. The 6min walk test （6MWT）, serum creatinine （Scr）, blood urea nitrogen （BUN） and blood uric acid （UA） were compared between groups, and the adverse reactions were observed. Results The effective rate of treatment in the observation group （95.65%） was significantly higher than that in the control group （80.43%） （P〈0.05）. After treatment, HR, MAP and respiratory rate in the observation group were lower than those in the control group （P%0.05）. After treatment, LVEF of the observation group was high- er than that of the control group, while CTR and NT-proBNP level, were lower than those in control group （P〈0.05）. After treatment, 6MWT of the observation group was longer than that of the control group, while Scr, BUN and UA levels were significantly lower （P〈0.05）. There was no significant difference in the incidence of adverse reactions be tween the two groups （P〉0.05）. Conclusion Treatment of refractory heart failure with sodium nitroprusside combined with dopamine can improve the heart and kidney function and related laboratory routine indexes, with good clinical cura tive effect and little adverse reaction.

关 键 词：硝普钠 多巴胺 难治性心衰 肾功能 

分 类 号：R541[医药卫生—心血管疾病]