单硝酸异山梨酯联合多巴胺治疗心力衰竭的疗效及安全性分析

The efficacy and safety of isosorbide mononitrate combined with dopamine in the treatment of heart failure

目的探讨单硝酸异山梨酯联合多巴胺治疗心力衰竭的疗效及安全性分析。方法选取2014年1月~2016年6月于周村区人民医院心血管内分泌科住院治疗的心力衰竭患者60例,随机分为实验组与对照组各30例,对照组患者采取常规利尿剂、血管紧张素转换酶抑制剂(ACEI)类、血管紧张素受体拮抗剂(ARB)类,醛固酮受体拮抗剂,β受体阻滞剂等基础治疗,实验组则在对照组的治疗基础上增加注射用单硝酸异山梨酯联合盐酸多巴胺注射液治疗。观察两组患者的临床效果、治疗前后心输出量(CO)、心脏每搏量(SV)、左室射血分数(LVEF),测定N末端脑钠肽前体(NT-proBNP)水平,测定6分钟步行距离;并对不良反应发生情况进行分析。结果实验组的总有效率(93.3%)明显高于对照组(66.7%),差异具有统计学意义(P<0.05);实验组的CO、SV、LVEF、NT-proBNP、6分钟步行距离均明显优于对照组,差异具有统计学意义(P<0.05);实验组的不良反应率(6.66%)明显低于对照组(23.34%),差异具有统计学意义(P<0.05)。结论采用单硝酸异山梨酯联合多巴胺治疗心力衰竭可以有效的改善患者的心功能,安全可靠。

Objective To investigate the efficacy and safety of isosorbide mononitrate combined withdopamine in the treatment of heart failure.Methods60patients with heart failure in Cardiovascular department ofEndocrinology;people's Hospital of Zhoucun District from January2014to June2016were enrolled in this study,which were randomly divided into experimental group and control group.The patients in the control group weretreated with conventional measures,such as diuretics,angiotensin converting enzyme inhibitors(ACEI),angiotensinreceptor antagonists(ARB),aldosterone receptor antagonists andβ-receptor antagonists,while the patients inthe experimental group received additional isosorbide mononitrate and dopamine hydrochloride.The levels ofcardiac output(CO),heart stroke volume(SV),left ventricular ejection fraction(LVEF),the N-terminal pro-brainnatriuretic peptide(NT-proBNP)and six-minute walk distance were measured before and after the treatment inboth groups.The occurrences of adverse reactions were analyzed.Results There were significant differences on thetotal effective rate between experimental group(93.3%)and control group(66.7%,P<0.05).The improvement of CO,SV,LVEF,NT-proBNP and six-minute walk distance in experimental group was higher than in control group.Theadverse reaction rate(6.66%)of experimental group was significantly lower than that of the control group(23.34%),the difference was statistically significant(P<0.05).Conclusion The use of isosorbide mononitrate combined withdopamine in the treatment of heart failure can effectively improve the patient's heart function,and its effect is safeand reliable.