呋塞米联合小剂量多巴胺对老年慢性心衰患者BNP的影响

目的 探讨呋塞米联合小剂量多巴胺治疗老年慢性心力衰竭(CHF)的临床疗效及对血浆脑钠肽(BNP)等的影响.方法 2015年1月至2016年12月期间铜陵市人民医院心内科住院的60例老年CHF患者按随机数表法分为观察组(n=30)和对照组(n=30).对照组在常规抗心衰基础上静脉注射呋塞米,观察组在对照组基础上再加用小剂量多巴胺治疗.评估两组治疗疗效,分析治疗前后血浆BNP等生化指标和超声心动图检查结果.结果 观察组患者的治疗总有效率[93.33%(28/30]明显高于对照组[76.67%(23/30)],差异有统计学意义(P<0.05);两组患者治疗前血浆BNP、C反应蛋白(CRP)水平、呼吸、全身症状程度比较差异均无统计学意义(P>0.05),治疗后两组BNP、CRP、呼吸、全身症状程度均明显改善,与治疗前比较差异均有统计学意义(P<0.05);治疗后观察组患者的BNP、CRP分别为(143.18±31.32)pg/mL、(5.44±1.12)mg/L,明显低于对照组的(180.14±25.10)pg/mL、(7.32±1.23)mg/L,差异均有统计学意义(P<0.05);观察组患者的呼吸困难、肺部啰音、水肿、乏力程度分别为(1.28±0.40)分、(1.19±0.31)分、(1.02±0.19)分、(1.21±0.22)分,明显低于对照组的(1.89±0.39)分、(1.79±0.31)分、(1.54±0.27)分、(1.61±0.24)分,差异均有统计学意义(P<0.05);观察组治疗后活动后无胸闷气促、心绞痛发生率为6.67%(2/30)、3.33%(1/30),明显低于对照组的26.67%(8/30)、20.00%(6/30),差异均有统计学意义(P<0.05).结论 呋塞米联合小剂量多巴胺可显著提高老年CHF的临床疗效,有效改善心功能与BNP水平,并可降低不良事件发生风险.

Effect of furosemide combined with low-dose dopamine on brain natriuretic peptide in elderly patients with chronic heart failure

Objective To investigate the clinical effect of furosemide combined with low-dose dopamine in the treatment of elderly patients with chronic heart failure (CHF) and the effect on brain natriuretic peptide (BNP). Methods Sixty elderly patients with CHF who admitted to Department of Cardiology in our hospital from January 2015 to December 2016 were randomly divided into observation group (n=30) and control group (n=30) ac-cording to the random number table. The control group received intravenous injection of furosemide on the basis of conventional anti-heart failure, and the observation group was treated with small doses of dopamine on the basis of the control group. The therapeutic effects between the two groups were evaluated. The biochemical indexes such as plasma BNP and results of echocardiography were analyzed before and after treatment. Results The total effective rate of treatment was significantly higher in the observation group than the control group, 93.33%(28/30) vs 76.67% (23/30), P<0.05. Before treatment, there were no significant difference between the two groups in levels of plasma BNP and C reactive protein (CRP), respiration and degree of systemic symptoms (P>0.05). After treatment, the above indexes were significantly improved compared with before treatment (P<0.05). After treatment, the levels of BNP, CRP, scores of dyspnea, pulmonary rales, edema, fatigue in observation group were (143.18 ± 31.32) pg/mL, (5.44±1.12) mg/L, (1.28±0.40), (1.19±0.31), (1.02±0.19), (1.21±0.22), significantly lower than (180.14±25.10) pg/mL, (7.32±1.23) mg/L, (1.89±0.39), (1.79±0.31), (1.54±0.27), (1.61±0.24) in the control group (P<0.05). The incidence rates of shortness of breath without chest pain, angina were 6.67%(2/30), 3.33%(1/30) in observation group after treatment, which were significantly lower than 26.67%(8/30), 20.00%(6/30) in the control group (P<0.05). Conclusion Furose-mide combined with low-dose dopamine can improve the efficacy of treating elderly patients with CHF, which can effectively improve cardiac function and BNP level, and reduce the risk of adverse events.