托拉塞米联合小剂量多巴胺治疗顽固性心力衰竭患者的临床疗效研究  

Therapeutic effect of torasemide combined small dose dopamine on patients with refractory heart failure

作　　者：徐建辉[1] 李睿[1] 李朋[1] 李屏[1] 杨海珍[1] 陈磊 

机构地区：[1]孝感市中心医院(武汉科技大学附属孝感医院)心内科二病区,湖北孝感市432100

出　　处：《心血管康复医学杂志》2018年第1期51-54,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:观察托拉塞米联合小剂量多巴胺对顽固性心力衰竭患者的临床疗效。方法:选择2015年1月至2016年9月我院收治的顽固性心力衰竭患者146例,按随机数字表法随机分为托拉塞米组和联合治疗组(接受托拉塞米联合小剂量多巴胺治疗),每组73例,均治疗7d。测量比较两组治疗前后左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、6min步行距离(6MWD)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平以及治疗后总有效率的差异。结果:与治疗前比较,两组治疗后LVEF、6MWD均显著升高和延长而LVEDd、IL-6、TNF-α水平均显著降低,P均=0.001;与托拉塞米组比较,联合治疗组治疗7d后LVEF[(30.69±4.52)%比(36.29±4.86)%]、6MWD[(271.21±48.32)m比(322.45±56.34)m]升高更明显而LVEDd[(54.17±7.64)mm比(46.52±6.52)mm]、IL-6[(34.65±6.13)μg/ml比(26.18±4.53)μg/ml]、TNF-α水平[(50.27±8.74)μg/ml比(37.48±7.04)μg/ml]降低更明显,P均=0.001。联合治疗组治疗总有效率显著高于托拉塞米组(90.4%比71.2%,P=0.03)。结论:托拉塞米联合小剂量多巴胺显著降低顽固性心力衰竭患者IL-6和TNF-α水平,改善心功能,提高临床疗效,值得推广。Objective： To observe therapeutic effect of torasemide combined small dose dopamine on patients with re- fractory heart failure （RHF）. Methods： A total of 146 RHF patients, who were treated in our hospital from Jan 2015 to Sep 2016, were selected. According to random number table, they were randomly and equally divided into torasemide group and combined treatment group （received torasemide combined small dose dopamine）, both groups were treated for 7d. Left ventricular ejection fraction （LVEF）, left ventricular end-diastolic dimension （LVEDd）, 6min walking distance （6MWD）, levels of interleukin 6 （IL-6） and tumor necrosis factor α （TNF-α） before and after treatment, and total effective rate were measured and compared between two groups. Results： Compared with before treatment, after treatment, there were significant rise in LVEF and 6MWD, and significant reductions in LVEDd, levels of IL-6 and TNF-α in two groups, P = 0. 001 all; compared with torasemide group after 7d treatment, there were significant rise in LVEF [- （30.69 ± 4. 52） % vs. （36.29 ± 4.86） % ] and 6MWD [ （271.21 ± 48.32） m vs. （322. 45 ± 56. 34） m], and significant reductions in LVEDd E （54. 17 ± 7. 64） mm vs. （46. 52± 6. 52） mm], levels of IL-6 [ （34. 65 ± 6.13） μg/ml vs. （26.18 ± 4. 53） μg/ml] and TNF-α [ （50.27 ± 8.74） μg/ml vs. （37.48 ± 7. 04） μg/ml] in combined treatment group, P = 0. 001 all. Total effective rate of combined treatment group was significantly higher than that of torasemide group （90.4% vs. 71.2%, P = 0.03）. Conclusion： Torasemide combined small dose dopamine can significantly reduce levels of IL-6 and TNF-α, improve cardiac function and therapeutic effect in RHF patients, which is worth extending.

关 键 词：心力衰竭 多巴胺 托拉塞米 

分 类 号：R541.61[医药卫生—心血管疾病]