呋塞米联合硝普钠注射液治疗顽固性心力衰竭的临床效果研究

Clinical Effect of Furosemide Combined with Sodium Nitroprusside Injection on the Refractory Heart Failure

目的:探讨呋塞米与硝普钠注射液联合治疗顽固性心力衰竭的临床效果及安全性。方法:选择2016年5月至2018年5月在我院进行治疗的90例顽固性心力衰竭患者,按照随机数字表法分为观察组和对照组。对照组给予基础治疗,观察组以对照组为基础加用呋塞米联合硝普钠注射液治疗。治疗后,观察和比较两组的临床疗效、治疗前后血清B型脑钠肽(BNP)、C-反应蛋白(CRP)水平及心功能[左室射血分数(LVEF)、左室舒张末容积指数(LVEDVI)、左室收缩末容积指数(LVESVI)、左室舒张早期与晚期充盈速度比值(E/A)]的变化。结果:治疗后,观察组总有效率(91.1%)明显高于对照组(66.7%)(P<0.05)。与治疗前相比,两组患者治疗后的血清BNP、CRP、LVEDVI、LVESVI水平均明显低于治疗前,LVEF、E/A明显高于治疗前(P<0.05);与对照组相比,观察组治疗后血清BNP、CRP、LVEDVI、LVESVI水平均明显降低,LVEF、E/A显著升高(P<0.05)。两组治疗期间均未发生严重不良反应。结论:与常规治疗相比,呋塞米联合硝普钠注射液治疗顽固性心力衰竭患者可更有效改善其心功能,提高其临床疗效,且安全性高。

Objective: To study the curative efficacy and security of furosemide combined with sodium nitroprusside in the treatment of refractory heart failure. Methods: 90 patients with refractory heart failure who were treated from May 2016 to May 2018 in our hospital were selected as the research objects and divided into the observation group and the control group according to different treatment. The control group was given basic treatment, while the observation group was given furosemide combined with sodium nitroprusside on the basis of control group. The clinical curative effect, changes of serum b-type brain natriuretic peptide(BNP), C-reactive protein(CRP) levels and heart function [left ventricular ejection fraction(LVEF), left ventricular end-diastolic volume index(LVEDVI), left ventricular contraction at the end of the volume index(LVESVI), left ventricular diastolic early and late filling speed ratio(E/A)] before and after treatment were compared between two groups. Results: After treatment, the total effective rate of observation group(91.1%) was obviously higher than that of control group(66.7%)(P<0.05). Compared with before treatment, the serum BNP and CRP levels, LVEDVI and LVESVI of both groups were significantly lower than those before the treatment, the LVEF, E/A were significantly higher than those before treatment(P<0.05). Compared with the control group, the serum BNP and CRP, and LVEDVI and LVESVI levels were significantly reduced, LVEF, E/A significantly higher of observation group after treatment(P<0.05). No serious adverse reaction was found between two groups during treatment. Conclusion: Compared with the conventional treatment, Furosemide combined with sodium nitroprusside could more effectively improve the cardiac function of patients with heart failure, enhance the clinical curative effect with high safety.