呋塞米联合小剂量多巴胺间歇静脉泵入治疗终末期心力衰竭合并利尿剂抵抗

目的观察比较间歇微量泵静脉泵入呋塞米和多巴胺与分次静脉推注呋塞米治疗终末期心衰伴利尿剂抵抗患者的疗效。方法将56例利尿剂抵抗性心力衰竭患者随机分为两组,对照组28例患者在进行常规抗心力衰竭治疗基础上,单纯分次静脉推注呋塞米治疗;观察组28例患者在常规抗心力衰竭治疗的基础上同时给予呋塞米和多巴胺间歇静脉泵入治疗。两组患者均治疗5 d。观察治疗前后两组患者在心功能分级（NYHA）、心功能指标、肾功能、尿量和体重等方面的变化。结果与对照组比较,观察组患者心功能分级（NYHA）明显改善,LVEF增加,6 min步行试验距离延长,尿量明显增加（P均〈0.05）。结论对终末期心衰伴利尿剂抵抗的患者,间歇静脉泵入呋塞米和多巴胺治疗的疗效优于单纯静脉推注呋塞米治疗。

Effect of intermittent intravenous infusion of furosemide and low-dose dobutamine on patients with end-stage heart failure and diuretics resistance

Objective To compare the effect of intermittent intravenous infusion of furosemide and low-dose dobutamine and multiple intravenous pushes of furosemide on patients with end-stage heart failure and diuretics resistance.Methods Fifty-six patients with end-stage heart failure and diuretic resistance were randomly and equally divided into control group and treatment group.Conventional treatments on heart failure were used in both groups.In addition,multiple intravenous pushes of furosemide was adopted in the control group while intermittent intravenous infusion of furosemide and low-dose dopamine in the treatment group.Both groups were treated for 5 days.Heart function classification（NYHA scores）,cardiac function index,and changes in renal function,urine volume and weight were observed before and after the treatment.Results Compared with the control group,NYHA scores in the treatment group were obviously improved（P 0.05）.Meanwhile,there is an increase in LVEF,urine volume and 6-minute-walktest distance（P 0.05）.Conclusion Intermittent intravenous infusion of furosemide and low-dose dopamine is superior to multiple intravenous pushes of furosemide in patients with end-stage heart failure and diuretics resistance.