小剂量多巴胺联合托伐普坦对顽固性心衰患者心功能恢复的影响  

Effect of low-dose dopamine combined with tolvaptan on cardiac function recovery in patients with refractory heart failure

作　　者：毛春发 MAO Chunfa(Tongzhaipu Town Health Center of Tanghe County,Nanyang 473404,China)

机构地区：[1]唐河县桐寨铺镇卫生院,河南南阳473404

出　　处：《临床医学研究与实践》2023年第9期22-25,共4页Clinical Research and Practice

摘　　要：目的探讨小剂量多巴胺联合托伐普坦对顽固性心衰患者心功能恢复的影响。方法选取我院2021年3月至2022年3月收治的68例顽固性心衰患者作为研究对象,随机将其分为常规组(34例,托伐普坦治疗)和观察组(34例,小剂量多巴胺联合托伐普坦治疗)。比较两组的临床疗效、心功能指标、心肌标志物、炎症因子水平及不良反应发生情况。结果观察组的治疗总有效率显著高于常规组,差异具有统计学意义(P<0.05)。治疗前,两组的左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室收缩末期容量(LVESV)、左心室舒张末期容量(LVEDV)比较,差异无统计学意义(P>0.05);治疗后,观察组的LVEF显著大于常规组,LVESD、LVESV、LVEDV均显著小于常规组,差异具有统计学意义(P<0.05)。治疗前,两组的B型脑钠肽(BNP)、心肌肌钙蛋白T(cTnT)、可溶性生长刺激表达基因2蛋白(sST2)、乳酸(LA)水平比较,差异无统计学意义(P>0.05);治疗后,观察组的BNP、cTnT、sST2、LA水平均显著低于常规组(P<0.05)。治疗前,两组的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、细胞间黏附分子-1(ICAM-1)水平比较,差异无统计学意义(P>0.05);治疗后,观察组的TNF-α、CRP、IL-6、ICAM-1水平均显著低于常规组,差异具有统计学意义(P<0.05)。观察组治疗期间的不良反应总发生率显著低于常规组,差异具有统计学意义(P<0.05)。结论小剂量多巴胺联合托伐普坦治疗顽固性心衰可有效改善患者的心功能,降低心肌标志物及炎症因子水平,且减少了不良反应的发生。Objective To investigate the effect of low-dose dopamine combined with tolvaptan on the cardiac function recovery in patients with refractory heart failure.Methods A total of 68 patients with refractory heart failure admitted in our hospital from March 2021 to March 2022 were selected as the research objects.The patients were randomly divided into conventional group(34 cases,tolvaptan treatment)and observation group(34 cases,low-dose dopamine combined with tolvaptan treatment).The clinical efficacy,cardiac function indexes,myocardial markers,inflammatory factors levels and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was significantly higher than that in the conventional group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)between the two groups(P>0.05);after treatment,the LVEF in the observation group was significantly higher than that in the conventional group,the LVESD,LVESV and LVEDV were significantly lower than those in the conventional group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of B-type natriuretic peptide(BNP),cardiac troponin T(cTnT),soluble growth stimulation expressed gene 2 protein(sST2)and lactic acid(LA)between the two groups(P>0.05);after treatment,the levels of BNP,cTnT,sST2 and LA in the observation group were significantly lower than those in the conventional group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6)and intercellular adhesion molecule-1(ICAM-1)between the two groups(P>0.05);after treatment,the levels of TNF-α,CRP,I

关 键 词：顽固性心衰 小剂量多巴胺 托伐普坦 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]