多巴胺联合硝普钠治疗老年重症心衰患者的疗效

目的:观察多巴胺联合硝普钠治疗老年重症心力衰竭患者的临床疗效及对患者心功能、胱抑素(CysC)、同型半胱氨酸(Hcy)、血浆脑钠肽(BNP)水平的影响。方法:本院的108例老年重症心力衰竭患者被随机均分为硝普钠组(给予常规治疗及硝普钠治疗)与联合治疗组(在硝普钠组基础上联合应用多巴胺治疗);治疗7d后,对比两组临床疗效,观察两组治疗前后的心功能指标和血清CysC、Hcy、血浆BNP水平变化,及治疗期间的不良反应。结果:联合治疗组总有效率显著高于常规治疗组(94.44%比77.78%,P=0.012)。治疗后,与硝普钠组比较,联合治疗组左室射血分数(LVEF)(42.86±9.23)%比(55.06±9.64)%]、每搏指数(SI)(29.04±5.36)比(35.48±5.71)]显著提高,左室舒张末期内径(LVEDd)(60.73±6.38)mm比(55.41±6.04)mm]、左室收缩末期内径(LVESd)(42.91±4.36)mm比(37.18±4.18)mm]显著缩小,血清CysC(1.42±0.24)mg/L比(1.07±0.18)mg/L]、Hcy(19.38±3.38)μmol/L比(17.09±2.97)μmol/L],血浆BNP(1968.74±159.76)pg/ml比(1105.96±118.53)pg/ml]水平显著降低(P均=0.001)。两组不良反应发生率无显著差异(P=0.781)。结论:多巴胺联合硝普钠治疗老年重症心衰患者的疗效显著优于硝普钠,可显著改善心功能,并可降低血清CysC、Hcy、血浆BNP水平,对预防病情恶化有积极意义。

Therapeutic effect of dopamine combined sodium nitroprusside on aged patients with severe heart failure

Objective:To observe therapeutic effect of dopamine combined sodium nitroprusside on aged patients with severe heart failure and its influence on cardiac function,levels of serum cystatin C(CysC),homocysteine(Hcy)and plasma brain natriuretic peptide(BNP).Methods:A total of 108 aged patients with severe heart failure in our hospital were selected,randomly and equally divided into sodium nitroprusside group(received routine treatment and sodium nitroprusside)and combined treatment group(received dopamine based on sodium nitroprusside group);after 7 d treatment,therapeutic effect,cardiac function indexes,levels of serum CysC,Hcy and plasma BNP before and after treatment,and incidence of adverse reactions during treatment were observed and compared between two groups.Results:Total effective rate of combined treatment group was significantly higher than that of routine treatment group(94.44%vs.77.78%,P=0.012).Compared with sodium nitroprusside group after treatment,there were significant rise in LVEF(42.86±9.23)%vs.(55.06±9.64)%],stroke index(SI)(29.04±5.36)vs.(35.48±5.71)]and significant reductions in left ventricular end-diastolic dimension(LVEDd)(60.73±6.38)mm vs.(55.41±6.04)mm],left ventricular end-systolic dimension(LVESd)(42.91±4.36)mm vs.(37.18±4.18)mm],levels of serum CysC(1.42±0.24)mg/L vs.(1.07±0.18)mg/L],Hcy(19.38±3.38)μmol/L vs.(17.09±2.97)μmol/L]and plasma BNP(1968.74±159.76)pg/ml vs.(1105.96±118.53)pg/ml]in combined treatment group,P=0.001 all.There was no significant difference in incidence rate of adverse reactions between two groups,P=0.781.Conclusion:Dopamine combined sodium nitroprusside possesses significant therapeutic effect than that of sodium nitroprusside group on aged patients with severe heart failure.It can significantly improve cardiac function,reduce levels of serum CysC,Hcy and plasma BNP,which possesses positive significance for preventing disease aggravation.