硝普钠并多巴胺治疗重症充血性心力衰竭临床观察

Therapeutic effect of sodium nitroprusside and dopamine in patients with grave chronic congestive heart failure

目的:研究硝普钠并多巴胺治疗重症充血性心力衰竭的临床疗效。方法:重症充血性心力衰竭患者64例,在常规治疗(吸氧、洋地黄制剂、利尿剂)的基础上,随机、双盲地给予硝普钠或硝酸甘油,按1∶1随机分为硝酸甘油组(对照组)和硝普钠组(治疗组),两组均联合应用多巴胺,用药前后检查超声心动图评估心功能,监测肝、肾功能,心率,血压变化及预后。结果:与硝酸甘油组比较,硝普钠并多巴胺治疗组患者的临床症状明显改善(93.8%∶78.1%,P<0.01),治疗后两组收缩压、舒张压明显下降,左室舒张末内径明显缩小,左室射血分数明显加强(P均<0.01),且硝普钠组优于对照组(P<0.05)。结论:使用血管扩张剂硝普钠,联合多巴胺治疗重症充血性心力衰竭有较好的协同作用,可有效地减轻心脏负荷,改善心脏收缩功能,而且患者的耐受性好,较为安全。

Objective： To study the therapeutic effect of sodium nitroprusside and dopamine in patients with grave chronic congestive heart failure （CHF）. Methods： A total of 64 patients with grave CHF were randomly divided into sodium nitroprusside group （32 cases, treated with sodium nitroprusside, routine therapy and dopamine） and nitroglycerin group （control group, 32 cases, treated with nitroglycerin, routine therapy and dopamine）. The heart function were determined by echocardiography. The blood pressure, heart rate, and function of heparin and kedney were examined. Results： Compared with nitroglycerin group, the total effective rate significantly increased （78. 1% ： 93.8%, P〈0.01）. The blood pressure, left ventricular end-diastolic dimension significantly decreased, and left ventricular ejection fraction increased after therapy in two groups （P〈0.01 all）, and those of sodium nitroprusside group were more than those of control group （P〈0. 05）. Conclusion： Therapeutic effect of sodium nitroprusside and dopamine is effective and safe in patients with grave chronic congestive heart failure.