摘要
目的 探讨应用硝普钠联合多巴酚丁胺治疗冠状动脉粥样硬化性心脏病( CHD)合并心力衰竭的临床治疗效果,并评估对其心功能的改善作用.方法 选取2017年5月至2018年4月永济市人民医院心内科收治的170例CHD合并心力衰竭患者,采用随机数表法将其随机分为硝普钠治疗组和联合治疗组,每组85例.硝普钠治疗组男45例,女40例,年龄(64. 27 ± 10. 61)岁,年龄范围为43~75岁.联合治疗组男46例,女39例,年龄(64. 56 ± 10. 78)岁,年龄范围为44~76岁.硝普钠治疗组常规基础上应用硝普钠治疗,联合治疗组同时应用多巴酚丁胺进行治疗.评估临床效果,评估患者肺动脉压、心功能,检测患者血流变学指标.评估临床效果,应用Lee氏心力衰竭评分量表评估患者临床症状改善;应用超声心动图评估患者每搏输出量(SV)、心输出量( CO)、左心室射血分数(LVEF),检测患者检测血清N末端脑钠肽前体( NT-proBNP)、肌酸激酶同工酶( CK-MB)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平.结果 联合治疗组有效率[80. 0% (68/85)]高于硝普钠治疗组[69. 4% (59/85)],差异有统计学意义(P<0. 05).治疗后硝普钠治疗组的Lee氏心力衰竭评分[(8. 26 ± 0. 93)分]高于联合治疗组[(6. 07 ± 0. 97)分],差异有统计学意义( P<0. 05).治疗后联合治疗组 SV[(46. 13 ± 1. 77) ml/次]、 LVEF [(54. 15 ± 1. 39)% ]、 CO [(5. 49 ± 0. 54)L/min]均高于硝普钠治疗组[(43. 05 ±1. 73)ml/次、(49. 04 ± 1. 56)% 、(4. 61 ± 0. 47)L/min],差异有统计学意义( P <0. 05 ).治疗后联合治疗组血 NT-ProBNP [( 452. 70 ± 102. 31 ) pg/ml]、 CK-MB [(1. 60 ± 0. 48)ng/ml]、hs-CRP[(21. 08 ± 6. 04) mg/L]、IL-6[(9. 31 ± 1. 48)ng/L]低于硝普钠治疗组[(609. 85 ± 108. 73)pg/ml、(2. 33 ± 0. 41)ng/ml、(26. 54 ± 5. 18)mg/L、(11. 07 ± 1. 42)ng/L],差异有统计学意义(P<0. 05).结论 应用硝普钠联合多巴酚丁胺治疗CHD合并心力衰竭患者,临床效果显著,能够减轻心功�
To investigate the clinical effect of sodium nitroprusside combined with dobutamine in the treatment of coronary atherosclerotic heart disease(CHD)with heart failure,and to evalu-ate the effect of improving cardiac function.Methods A total of 170 CHD patients with heart failure who were admitted from May 2017 to April 2018 were randomly divided into the sodium nitroprusside treatment group and combined treatment group,with 85 patients in each group.In the sodium nitroprusside treatment group,45 males and 40 females were aged(64.27±10.61),ranging from 43 to 75 years old.In the com-bined treatment group,46 males and 39 females were aged(64.56±10.78)years,ranging from 44 to 75 years.Sodium nitroprusside was used in the treatment group,while dobutamine was used in the combined treatment group.Clinical effect was evaluated,pulmonary artery pressure and cardiac function were evalua-ted,and hemorheology indexes were detected.Clinical effect was evaluated,and clinical symptom improve-ment was assessed by Lee′s heart failure score scale.Cardiac output per stroke volume(SV),cardiac output(CO)and left ventricular ejection fraction(LVEF)were assessed by echocardiography,and serum levels of NT-proBNP,CK-MB,hs-CRP and IL-6 were detected.Results The effective rate of combined treatment group[80.0%(68/85)]was higher than that of sodium nitroprusside treatment group[69.4%(59/85)],and the difference was statistically significant(P<0.05).After treatment,Lee′s heart failure score(8.26±0.93)in sodium nitroprusside treatment group was higher than that in combination treatment group(6.07±0.97),(P<0.05).After treatment,SV[(46.13±1.77)ml/time],LVEF[(54.15±1.39)%],CO[(5.49±0.54)L/min]in the combined treatment group were all higher than that in the sodium nitroprus-side treatment group[(43.05±1.73)ml/time,(49.04±1.56)%,(4.61±0.47)L/min],(P<0.05).After treatment,blood levels of NT-ProBNP[(452.70±102.31)pg/ml],CK-MB[(1.60±0.48)ng/ml],hs-CRP[(21.08±6.04)mg/L],and IL-6[(9.31±1.48)ng/L]in the combined treatment group were lowe
作者
张艳婷
梁天明
申永琦
Zhang Yanting;Liang Tianming;Shen Yongqi(Department of Cardiology,Yongji People′s Hospital,Yongji 044500,China)
出处
《中国临床实用医学》
2019年第4期26-29,共4页
China Clinical Practical Medicine
关键词
冠状动脉粥样硬化性心脏病
心力衰竭
硝普钠
多巴酚丁胺
心功能
Coronary atherosclerotic heart disease
Heart failure
Sodium nitroprusside
Dobu-tamine
Cardiac function
