摘要
目的探讨静脉联合应用硝酸异山梨酯和盐酸艾司洛尔治疗伴快速心率急性心力衰竭(acute heart failure,AHF)的疗效和安全性。方法 2016年1月至2018年1月,清华大学第一附属医院收治的伴快速心率AHF患者75例,分为联合用药(combined treatment,CT)组、硝酸异山梨酯(isosorbide dinitrate,ID)组和盐酸艾司洛尔(esmolol hydrochloride,EH)组,每组25例。CT组采用ID联合EH静脉泵入治疗,ID组仅采用ID静脉泵入,EH组仅采用EH静脉泵入。三组患者用药方法相同,用药时间均为48h。观察比较三组患者治疗前后的肌酸激酶(creatine kinase,CK);肌酸激酶MB同工酶(creatine kinase-MB isoenzyme,CK-MB);肌钙蛋白T (troponin T,TnT);肌红蛋白(myoglobin,MYO);N-末端B型钠尿肽原(N-terminal B natriuretic peptide,NT-proBNP);左心室射血分数(left ventricular ejection fraction,LVEF);心率;尿量和不良反应发生率。结果与治疗前比较,CT组、ID组、EH组患者治疗后的CKMB (P=0.00、0.017、0.024);TnT (P=0.00、0.031、0.028);NT-proBNP (P=0.00)和心率(P=0.00)均降低,LVEF (P=0.00)和尿量(P=0.00)增加,CK和MYO差异无统计学意义(P>0.05);与ID组和EH组相比,CT组CK-MB、TnT、NT-proBNP和心率水平降低,差异有统计学意义(P<0.05),LVEF和尿量增加,差异有统计学意义(P<0.05)。三组的不良反应发生率差异无统计学意义(P>0.05)。结论静脉注射硝酸异山梨酯和盐酸艾司洛尔治疗伴快速心率AHF的疗效、安全性优于单独应用硝酸异山梨酯或盐酸艾司洛尔。
Objective To evaluate the efficacy and safety of intravenous administration of isosorbide dinitrate and esmolol hydrochloride combination in the treatment for acute heart failure（AHF）with tachycardia.Methods Seventy-five AHF patients with tachycardia treated in The Frist Hospital of Tsinghua University from January 2016 to January 2018 were selected and classified based on whether they were given intravenously the combination of isosorbide dinitrate and esmolol hydrochloride（CT group,n=25）,isosorbide dinitrate alone（ID group,n=25）or esmolol hydrochloride alone（EH group,n=25）for 48 hours.Blood samples were collected and the pre-and post-therapeutic serum levels of creatine kinase（CK）,creatine kinase-MB isoenzyme（CK-MB）,troponin T（TnT）,myoglobin（MYO）,N-terminal B natriuretic peptide（NT-proBNP）were measured and compared.Meanwhile, the left ventricular ejection fraction（LVEF）, heart rate,urine volume and adverse event were recorded and compared as well. Results After the treatment,the serum levels of CK-MB（P=0.00,0.017,0.024）,TnT（P=0.00,0.031,0.028）and NT-proBNP（P=0.00）as well as heart rate（P=0.00）were all significantly lowered,while the serum level of LVEF（P=0.00）and urine volume（P=0.00）were all significantly elevated and the levels of CK（P〉0.05）and MYO（P〉0.05）remained relatively unchanged in all three groups.After the treatment,the serum levels of CKMB,TnT and NT-proBNP as well as heart rate were significantly lower in CT group than the other two groups（P〈0.05）,while the serum level of LVEF and urine volume were significantly higher（P〈0.05）.The differences of incidence of adverse events were not statistically significance among three groups（P〉0.05）.Conclusions The efficacy of intravenous administration of a drug combination with isosorbide dinitrate and esmolol hydrochloride in the treatment for acute heart failure with tachycardia is superior to that of isosorbide dinitrate or esmolol hydrochloride alone,while the drug sa
作者
刘轶君
李蕾
杨倩
LIU Yi-jun;LI Lei;YANG Qian(The Frist Hospital of Tsinghua University,Beijing 100016,China)
出处
《中国预防医学杂志》
CAS
CSCD
2018年第10期721-725,共5页
Chinese Preventive Medicine
基金
国家自然科学基金资助项目(31700674)
关键词
硝酸异山梨酯
盐酸艾司洛尔
静脉注射
快速心率
急性心力衰竭
Isosorbide dinitrate
Esmolol hydrochloride combination
Intravenous administration
Tachycar-dia
Acute heart failure
