硝普钠与心先安配伍治疗难治性充血性心力衰竭46例的疗效观察

目的 :探讨硝普钠和心先安联合治疗难治性充血性心力衰竭的效果。方法 :将92例难治性充血性心力衰竭 ( CHF)患者随机分为硝普钠治疗组 ( A组 )及联合治疗组 ( B组 ) ,每组 46例。 A组采用常规治疗 ,同时加用 5 %葡萄糖 5 0 ml+硝普钠 2 5 mg从每分 0 .1 2 5 μg/kg开始微泵连续注射 ,逐渐增加速度 ,但不超过每分钟 5 μg/kg,以血压不低于 1 2 /8k Pa为度 ,连续应用 7d。B组在 A组治疗基础上加 5 %葡萄糖 2 5 0 ml+心先安 1 5 0 mg静脉点滴 2～ 3h,每天 1次 ,连续应用 7d。结果 :A组显效 1 5例 ,有效 1 8例 ,无效 1 3例 ,总有效率为 71 .7%。B组显效 2 9例 ,有效 1 3例 ,无效 4例 ,总有效率为 91 .3%。 B组明显优于 A组( P<0 .0 5 )。两组治疗后心率 ( HR)、血压 ( BP)、左室舒张末期容积 ( EDV)、左室收缩末期容积 ( ESV)、左室射血分数 ( L VEF)均有显著改善 ( P<0 .0 1 ) ,B组治疗后 HR及 EDV、ESV、L VEF与 A组比较有显著性差异 ( P<0 .0 5 )。两组均未发生明显不良反应。结论 :硝普钠配伍心先安治疗难治性充血性心力衰竭效果好

Curative effect observation of sodium nitroprusside combined with meglumine cyclic adenylate in the treatment of 46 patients with refractory congestive heart failure

Objective : To examine the clinic effect of sodium nitroprusside combined with meglumine cyclic adenylate in patients with refractory congestive heart failure(CHF) . Methods: Ninety-two patients with refractory CHF were randomly assigned to receive sodium nitroprusside (group A, n=46) and combined with meglumine cyclic adenylate (group B , n=46). Group A was routinely treated with the continuous intravenous infusion of sodium nitroprusside ;the first dose was 0.125μg/kg/min but no more than 5μg/kg/min for 7 days, while blood pressure was no less than 12/8kPa . Group B was given sodium nitroprusside plus meglumine cyclic adenylate(150mg) injection for 7 days . Results: The group B was significantly better than the group A(91.3% vs 71.7%, P<0.05). A significant improvement of heart rate(HR) , blood pressure , left ventricular end-diastolic volume (EDV) , end-systolic volume (ESV), ejection fraction(EF) after treatment in 2 groups was found(P<0.01). There is a significant difference in HR, EDV, ESV, EF between 2 groups (P<0.05). No side effect was found . Conclusion: Sodium nitroprusside combined with meglumine cyclic adenylate was significantly effective in refractory CHF.