多巴酚丁胺与左西孟旦注射液联合治疗ADHF患者的疗效分析及对血液动力学的影响

Efficacy analysis of dobutamine and levosimendan injection in the treatment of patients with ADHF and effects on hemodynamics

目的:探讨多巴酚丁胺与左西孟旦注射液联合治疗ADHF患者的疗效分析及对血液动力学的影响。方法:选取2014年1月~2017年1月我院门诊收治的100例ADHF患者,按照随机数字表法,将所有患者分为观察组(n=50)和对照组(n=50)。对照组采用多巴酚丁胺治疗,观察组采用多巴酚丁胺联合左西孟旦注射液。比较两组患者临床疗效、基础监测指标、心脏功能指标、血流动力学指标、血清生化指标及不良反应发生率。结果:观察组的总有效率(94.0%)显著高于对照组(70.0%)。治疗后,观察组患者心率、呼吸频率、收缩压、SaO2、24h尿量、sCr及eGFR改善情况均显著优于对照组。观察组患者SDNN、SDANNindex、rMSSD、PNN50、LF、HF改善程度均显著优于对照组。NT-proBNP、ET-1、NE改善情况均显著优于对照组。观察组各不良反应发生率(心律失常、室性早搏、低血压、低血钠、头痛、胃肠道反应)均显著低于对照组。结论:多巴酚丁胺与左西孟旦注射液联合治疗ADHF患者疗效确切,可显著改善患者心脏功能,且不良反应少。

Objective To investigate the effect of dobutamine and levosimendan injection in the treatment of patients with ADHF and its influence on hemodynamics.Methods From January 2014 to January 2017,100 patients with acute decompensated heart failure admitted to our hospital were selected.All patients were divided into observation group and control group according to random number table method,50 cases in each group.The control group was treated with dobutamine and the observation group was treated with dobutamine and levosimendan injection.Clinical efficacy,basic monitoring indicators,cardiac function indicators,hemodynamic parameters,serum biochemical indicator and adverse reactions were compared.Results The total effective rate of the observation group (94%) was higher compared to the control group (70%) significantly.After treatment,the observation group heart rate,respiratory rate,systolic blood pressure,SaO2,24h urine volume,sCr and eGFR improvement were significantly better than the control group.The improvement of SDNN,SDANNindex,rMSSD,PNN50,LF,HF in the observation group was better compared to the control group significantly.NT-proBNP,ET-1,NE improvement were significantly better than the control group.The incidence of adverse reactions in the observation group was lower compared to the control group significantly.Conclusion Dobutamine combined with Levosimendan Injection in the treatment of patients with ADHF is effective,can significantly improve the patient’s cardiac function,and less adverse reactions.