尼卡地平联合多巴酚丁胺对老年慢性肺心病患者急性加重期的作用分析

Effects of combination therapy of nicardipine and dobutamine on elderly patients with chronic pulmonary heart disease in acute exacerbation phase

目的观察尼卡地平联合多巴酚丁胺在老年慢性肺心病急性加重期的作用。方法62例肺心病急性加重期的老年患者随机分为治疗组34例和对照组28例,2组均给予常规治疗,治疗组则在此基础上给予尼卡地平和多巴酚丁胺。治疗期间观察2组症状、体征、肺动脉收缩压(PASP)、血气(PaO2、PaCO2)、心率(HR)、左室射血分数(LVEF)、右室流出道内径(RVOTD)、右心室内径(RVD)、右心肺动脉内径(RPAD)、好转时间以及不良反应,并进行比较。结果2组临床疗效比较,治疗组总有效率为88.2%,对照组总有效率为57.1%,差异有统计学意义(P<0.05);2组治疗后PASP、PaO2、PaCO2、HR、LVEF以及RVOTD、RVD、RPAD比较,治疗组较对照组有明显改善,差异均有统计学意义(P<0.05或P<0.01);2组显效时间比较,治疗组显效快,差异有统计学意义(P<0.01);2组治疗期间均未出现明显不良反应。结论尼卡地平联合多巴酚丁胺对老年慢性肺心病急性加重期作用明显,不良反应较少。

Objective To investigate the effect of the combination therapy of nieardipine and dobutamine on chronic pulmonary heart disease in acute exacerbation phase. Methods Sixty-two patients with pulmonary heart disease in acute exacerbation phase were randomly divided into the treatment group（ n = 34） and the control group（ n = 28 ）. Both groups received conventional treatment, and the treatment group received additional nieardipine and dobutamine on this basis. The symptoms ,signs ,pulmonary artery systolic pressure（ PASP）, blood gas（ PaO2, PaCO2 ） ,heart rate（ HR）, left ventricular ejection fraction （LVEF）, right ventricular outflow tract diameter（ RVOTD）, right ventrieular diameter（ RVD）, right pulmonary artery diameter（RPAD） and adverse reactions were observed during the treatment and were contrasted between the two groups. Results The total efficiency of treatment group （ 88.2% ） was significantly higher than that of control group （57. 1%, P 〈 0. 05 ） ; Compared with the control group, the levels of PASP, PaO2 , PaCO2 , HR, LVEF, RVOTD,RVD and RPAD were significantly improved in the treatment group after treatment（ P 〈0. 05 or P 〈0. 01 ） ; The therapeutic effects appeared earlier in the treatment group than that in the control group（P 〈0. 01 ）. Both groups showed no obvious adverse reactions. Conclusions Nicardipine combined with dobutamine in the treatment for chronic pulmonary heart disease in the elderly in acute exacerbation phase have remarkable efficacy, but fewer adverse reactions.