硝普钠联合多巴胺持续静脉泵入对老年顽固性心衰的效果及安全性探讨  

Effect and safety of sodium nitroprusside combined with dopamine continuous intravenous infusion in the treatment of elderly patients with refractory heart failure

作　　者：罗立 LUO Li(Yangjiang People's Hospital,Yangjiang 529500,China)

机构地区：[1]阳江市人民医院,529500

出　　处：《中国现代药物应用》2022年第13期18-21,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨老年顽固性心力衰竭(心衰)患者治疗中硝普钠与多巴胺合用持续性静脉泵入的临床疗效及用药安全性。方法90例老年顽固性心衰患者,根据随机数字表法分为对照组和观察组,每组45例。对照组患者在常规抗心衰治疗基础上联用多巴胺治疗,观察组患者在常规抗心衰基础上持续静脉泵入硝普钠与多巴胺治疗。比较两组患者临床疗效,治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、每搏输出量(SV)],生命体征指标(收缩压、舒张压、心率),不良反应发生情况。结果观察组患者治疗总有效率95.56%明显高于对照组的82.22%,差异具有统计学意义(P<0.05)。治疗后,观察组患者的LVEF(46.18±9.52)%、SV(55.89±5.33)ml均明显大于对照组的(40.76±8.26)%、(42.56±5.36)ml,LVEDD(51.81±4.65)mm、LVESD(38.05±4.42)mm均明显小于对照组的(60.01±5.52)、(41.35±3.36)mm,差异具有统计学意义(P<0.05)。治疗后,两组患者的收缩压、舒张压、心率均明显低于本组治疗前,且观察组患者的收缩压(130.54±10.02)mm Hg(1 mm Hg=0.133 kPa)、舒张压(78.81±10.02)mm Hg、心率(84.68±7.24)次/min均明显低于对照组的(146.71±13.32)mm Hg、(87.42±11.27)mm Hg、(105.12±9.92)次/min,差异具有统计学意义(P<0.05)。两组患者的不良反应发生率比较差异无统计学意义(P>0.05),且通过对症处理后均消失,均未进行特殊干预。结论持续性静脉泵入硝普钠与多巴胺治疗老年顽固性心衰患者,不仅可有效降低患者血压、心率等指标,同时有利于改善患者心功能,疗效确切,可提高预后效果,且用药安全性也得到保障。Objective To discuss the clinical efficacy and safety of sodium nitroprusside combined with dopamine continuous intravenous infusion in the treatment of elderly patients with refractory heart failure.Methods A total of 90 elderly patients with refractory heart failure were divided into control group and observation group according to random numerical table,with 45 cases in each group.Patients in the control group received conventional anti-heart failure treatment combined with dopamine therapy,while patients in the observation group received continuous intravenous infusion of sodium nitroprusside and dopamine on the basis of conventional antiheart failure treatment.Both groups were compared in terms of clinical efficacy,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),stroke volume(SV)],vital signs(systolic blood pressure,diastolic blood pressure,heart rate)before and after treatment,and occurrence of adverse reactions.Results The total effective rate of treatment in the observation group was 95.56%,which was significantly higher than 82.22% in the control group,and the difference was statistically significant(P<0.05).After treatment,the LVEF(46.18±9.52)% and SV(55.89±5.33)ml of the observation group were significantly higher than(40.76±8.26)% and(42.56±5.36)ml of the control group,and the LVEDD(51.81±4.65)mm and LVESD(38.05±4.42)mm were significantly smaller than(60.01±5.52)and(41.35±3.36)mm of the control group.All the differences were statistically significant(P<0.05).After treatment,the systolic blood pressure,diastolic blood pressure and heart rate of the two groups were significantly lower than those of this group before treatment;the systolic blood pressure(130.54±10.02)mm Hg(1 mm Hg=0.133 kPa),diastolic blood pressure(78.81±10.02)mm Hg,heart rate(84.68±7.24)times/min in the observation group were significantly lower than(146.71±13.32)mm Hg,(87.42±11.27)mm Hg and(105.12±9.92)times/min

关 键 词：硝普钠 多巴胺 持续静脉泵入 老年顽固性心力衰竭 临床价值 

分 类 号：R541.6[医药卫生—心血管疾病]