硝普钠和多巴胺联合治疗慢性心力衰竭临床观察

Clinical observation of combined therapy of sodium nitroprusside and dopamine in chronic heart failure

目的慢性心力衰竭患者病情若未得到有效控制,将严重威胁患者生命安全。本研究分析慢性心力衰竭患者采用硝普钠与多巴胺治疗的临床价值。方法将本院2018-05-01-2019-04-01接收的82例慢性心力衰竭患者作为研究对象,根据性别、年龄、病程等基线特征组间平衡的原则选择观察组与对照组,每组41例。对照组采用常规治疗,观察组在其基础上联合硝普钠、多巴胺治疗。比较两组心功能、6min步行试验(6minute walking test,6MWT)、临床疗效和不良反应发生情况。结果治疗后,观察组左心室收缩末期内径为(37.10±5.39)mm,低于对照组的(43.08±6.31)mm,t=4.614,P=0.001;左心室舒张末期内径为(47.33±7.40)mm,低于对照组的(56.19±7.62)mm,t=5.341,P=0.001;左心室射血分数为(49.99±5.10)%,高于对照组的(44.63±4.30)%,t=5.145,P=0.001。治疗后,观察组6MWT为(156.88±1.95)m,高于对照组的(121.08±2.49)m,t=72.480,P=0.001。观察组临床总有效率为97.56%,高于对照组的78.05%,χ2=7.289,P=0.007。结论慢性心力衰竭患者应用多巴胺联合硝普钠可提升临床疗效,改善机体耐力和心功能。

OBJECTIVE If the condition of patients with chronic heart failure is not effectively controlled,it will seriously threaten the lives of patients.This study analyzes the clinical value of treatment of chronic heart failure with sodium nitroprusside and dopamine.METHODS A total of 82 chronic heart failure patients our hospital from May 1,2018 to April 1,2019 were selected as the research object,the observation group and the control group were selected according to the principle of balance between baseline characteristics such as gender,age,disease course,etc,with 41 cases in each group.The control group received conventional treatment,and the observation group combined with sodium nitroprusside and dopamine.Heart function,6 minute walking test(6 MWT),clinical efficacy,and adverse reactions were compared between the two groups.RESULTS After treatment,the left ventricular end systolic inner diameter of the observation group was(37.10±5.39)mm,which was lower than that of the control group(43.08±6.31)mm,t=4.614,P=0.001.The left ventricular end diastolic inner diameter was(47.33±7.40)mm,which was lower than that of the control group(56.19±7.62)mm,t=5.341,P=0.001.The left ventricular ejection fraction was(49.99±5.10)%,which was higher than that of the control group(44.63±4.30)%,t=5.145,P=0.001.After treatment,the 6 MWT of the observation group was(156.88±1.95)m,which was higher than that of the control group(121.08±2.49)m,t=72.480,P=0.001.The total clinical effective rate in the observation group was 97.56%,which was higher than that of the control group 78.05%,χ~2=7.289,P=0.007.CONCLUSION The use of dopamine combined with sodium nitroprusside in patients with chronic heart failure could improve clinical efficacy,body endurance and cardiac function.