酚妥拉明、多巴胺并生脉注射液治疗高寒高原地区肺心病急性加重期的疗效观察

Effect of Phentolamine, Dopamine and Shengmai Injection on Patients with Pulmonary Heart Disease at Acute Attack Stage in Cold Highland

目的观察应用小剂量酚妥拉明、多巴胺并生脉注射液治疗高寒高原地区肺心病急性加重期患者的效果。方法高寒高原地区(西宁市及其附近地区,海拔2200～3600m,全年平均气温5.6℃,冬季-8.1℃)肺心病患者91例,随机分为对照组(46例)及观察组(45例)。对照组应用吸氧、有效抗生素、祛痰平喘、利尿、强心等常规治疗,观察组在常规治疗的基础上加用酚妥拉明20mg,多巴胺20mg加入5%～10%葡萄糖250ml,缓慢静脉滴入,10滴/min,生脉注射液60ml加人5%～10%葡萄糖250ml缓慢静脉滴入,1/d。两组病人在治疗前和治疗3周后测定动脉血气(Pa02,PaCO2,PH值)、静脉血红蛋白(Hb)、红细胞比容(HCT)、FEV1预计值(%)和PEF预计值(%)。结果两组患者治疗后的各项指标与治疗前的指标均有显著性差异(P<0.01),并且,在治疗后,观察组的监测指标与对照组的指标差异也有显著性(P<0.01)。结论酚妥拉明,多巴胺并生脉注射液能降低高寒高原肺心病临床症状并改善血气指标及肺功能。

Objective To study the effect of low dose phentolamine, dopamine and shengmai injection on the patients with pulmonary heart disease at acute attack stage in cold highland. Methods All the 91 patients in cold highlands (Xining city and the areas nearby, at the height of 2 200~3 600 meters above sea level), ill with pulmonary heart disease at acute attack stage, were assigned to two groups at random: experimental group and control group. The patients in control group were treated with routine therapies: oxygen inhalation, antibiotics, antispasmodics, antigaspics, apophlegmatics, diuretics, cardiacs and so on. Whereas, the patients in experimental group were additionally treated with phentolamine (20 mg) plus dopamine (20 mg) added to 250 ml of 5~10% glucose injection venously dropping (10 drops per minute), and with 60 ml of shengmai injection added to 250 ml of the same solution slowly dropping venously once per day. Arterial blood's PH, Pa0 2 and PaCO 2, and venous blood's hemoglobin (Hb), haematocrit (HCT), FEVl% and PEF% were analyzed in all cases before treatment and after three weeks' treatment. Results The targets tested in both groups after and before treatment were significantly different (P<0. 01), and after treatment, the targets in experimental group were significantly different from that in control group (P<0. 01). Conclusion Phentolamine, dopamine and shengmai injection, besides routine therapies not only improve the patient's symptoms of pulmonary heart disease in acute exacerbation phase in cold highland but also improve the values of arterial blood gas analysis and the function of lung.