硝普钠、多巴胺、多巴酚丁胺在治疗扩张型心肌病顽固性心力衰竭中的疗效观察

The Observed of Nitroprusside, Dopamine, Dobutamine in the Treatment of Dilated Cardiomyopathy Efficacy Refractory Heart Failure

目的探讨硝普钠、多巴胺及多巴酚丁胺联合使用治疗扩张型心肌病顽固性心力衰竭的有效性及安全性。方法选取我院收治的扩张型心肌病顽固性心力衰竭患者共60例,并以随机数字表法方式将其分成2组,每组30例,将其中实施一般治疗、利尿剂、洋地黄制剂、血管紧张素转移酶抑制剂及抗心律失常治疗等常规措施处理者纳入对照组,另将在此条件下施加硝普钠、多巴胺及多巴酚丁胺等药物配合治疗者纳入观察组,分析并评估两组病例的临床治疗效果,总结积累临床治疗经验。结果观察组治疗后可取得93.3%的临床总疗效,显著高于对照组(P<0.05),且观察组治疗后,在改善临床症状,提高左室射血分数(LVEF)、心排血量(CO)等方面均较其治疗前对照组更具优越性(P<0.05),在安全性方面,两组治疗期间均未见不良反应。结论为扩张型心肌病顽固性心力衰竭患者在常规治疗基础上联用硝普钠、多巴胺及多巴酚丁胺治疗有确切疗效,且安全可靠。

Objective To study the efficacy and safety of the combination treatment in dilated cardiomyopathy with refractory heart failure by sodium nitrate, dopamine and dobutamine. Methods 60 patients diagnosis as dilated cardiomyopathy with refractory heart failure in the hospital were randomly and divided into 2 group＇s by the number table method（30 cases in each group）. Among them, the patients in the control group were treated by diuretics, oxygen and angintensin transferase inhibition. And the patients in the observation group were treated by diuretics, oxygen and angiotensin transferase inhibition. Then clinical treatment outcome of cases in was analyzed and evaluated of two groups of, and treatment experience was summaried. Results The total clinical curative effect in the observation group after treatment can obtain 93.3% of, it is more ideal than the control group（70.0%）, more significant difference （P〈0.05）. And left ventrieular ejection fraction observation group after treatment of （LVEF）, cardiac index （CI） and heart rate value were much more superiority than before the treatment, control group （P〈0.05）. And in terms of safety, there were no serious symptoms of two groups during treatment. Conclusion For DCM patients with refractory heart failure combination, sodium nitrate, dopamine and dobutamine treatment has the exact effect, safe and reliable, suitable for popularization in future clinical application.