多巴酚丁胺联合福辛普利对顽固性心衰患者心功能及氧化应激的影响  

Effects of Dobutamine combined with Fosinopril sodium on cardiac function indexes and oxidative stress response in patients with refractory heart failure

作　　者：杨业龙 李小旭 廖明巧 Yang yelong;Li xiaoxu;Liao mingqiao(Department of Intensive Care Medicine,Zhenping Hospital of Traditional Chinese Medicine,Zhengping,474250,China;Department of Cardiology,Nanyang Nanshi Hospital,Nanyang,473000,China)

机构地区：[1]镇平县中医院,474250 [2]南阳南石医院,473000

出　　处：《临床心电学杂志》2024年第5期359-363,共5页Journal of Clinical Electrocardiology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20221043)。

摘　　要：目的探讨多巴酚丁胺联合福辛普利钠治疗顽固性心力衰竭(Refractory Heart Failure,RHF)的应用价值。方法回顾性选取我院2020年1月至2023年6月收治的96例RHF患者纳入研究,按不同治疗方法分为对照组(n=48)、研究组(n=48)。两组均予以常规对症治疗,在此基础上参照组采用福辛普利钠治疗,研究组在对照组基础上加用采用多巴酚丁胺治疗。比较两组疗效,治疗前、后心功能指标(左室收缩/舒张末内径、左心室射血分数)、生存质量评分、6分钟步距离、心肌损伤指标[心肌肌钙蛋白T(cTnT)、N末端脑钠肽前体(NT-pro BNP)]、氧化应激指标[髓过氧化物酶(MPO)、丙二醛(MDA)、超氧化物歧化酶(SOD)]及治疗期间不良反应发生情况。结果研究组总有效率(45/48)(93.75%)高于对照组(38/48)(79.17%)(P<0.05);治疗7天后,研究组左心室射血分数水平高于对照组,左室舒张/收缩末内径水平低于对照组(P<0.05);治疗7天后,研究组MLHFQ评分低于参照组(P<0.05);治疗7天后,研究组6分钟步行距离长于对照组(P<0.05);治疗7天后,研究组NT-pro BNP及c Tn T水平均低于对照组(P<0.05);治疗7天后,研究组SOD水平高于对照组,MDA、MPO水平均低于对照组(P<0.05);研究组不良反应总发生率(6/48)(12.50%)与对照组(4/48)(8.33%)相比,差异无统计学意义(P>0.05)。结论多巴酚丁胺联合福辛普利钠治疗RHF患者疗效显著,可有效抑制氧化应激反应,减轻心肌损伤,改善心功能,延长6分钟步行距离,且能保障用药安全性。Objective To investigate the application value of Dobutamine combined with Fosinopril sodium in the treatment of Refractory heart failure(RHF).Methods A total of 96 cases of RHF patients admitted to our hospital from January 2020 to June 2023 were retrospectively selected and divided into reference group(n=48)and study group(n=48)according to different treatment methods.Both groups were given conventional symptomatic treatment,on the basis of which the reference group was treated with Fosinopril sodium,and the study group was treated with Dobutamine on the basis of the reference group.Compare the efficacy of the two groups as well as cardiac function indicators(Left Ventricular End-Systolic/Diastolic Diameter,Left Ventricular Ejection Fraction),quality of life score,6-minute step distance,myocardial injury indexes[cardiac troponin T(c Tn T),N-terminal brain natriuretic peptide precursor(NT-pro BNP)],oxidative stress indexes[myeloperoxidase(MPO),malondialdehyde(MDA),superoxide dismutase(SOD)]before and after treatment and adverse reactions during treatment.Results The total effective rate of the study group(45/48)(93.75%)was higher than that of the control group(38/48)(79.17%)(P<0.05).After 7 days of treatment,the level of left ventricular ejection fraction in study group was higher than that in reference group,and the level of left ventricular end-diastolic/systolic diameter was lower than that in reference group(P<0.05).After 7 days of treatment,the MLHFQ score of the study group was lower than that of the reference group(P<0.05);After 7 days of treatment,the walking distance of 6 min in the study group was longer than that in the control group(P<0.05).After 7days of treatment,the levels of NT-pro BNP and c Tn T in the study group were lower than those in the reference group(P<0.05).After 7 days of treatment,SOD level of the study group was higher than that of the reference group,MDA and MPO levels were lower than those of the reference group(P<0.05).There was no significant difference in the total incidence of

关 键 词：多巴酚丁胺 福辛普利钠 顽固性心力衰竭 心功能指标 氧化应激反应 生活质量 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]