托伐普坦联合小剂量多巴胺治疗顽固性心力衰竭的效果

Efficacy of tolvaptan combined with low-dose dopamine in the treatment of refractory heart failure

目的:观察托伐普坦联合小剂量多巴胺治疗顽固性心力衰竭的效果。方法:抽取2017年1月至2019年12月焦作煤业(集团)有限责任公司中央医院难治性心力衰竭患者150例,根据不同用药方案分为对照组(68例)和联合组(82例),对照组根据个体需求给予常规治疗,同时给予托伐普坦治疗;联合组在对照组基础上给予小剂量多巴胺治疗,比较两组临床治疗效果及治疗前后心功能指标的变化情况。结果:治疗过程中均未出现死亡患者。联合组患者治疗总有效率(97.56%)高于对照组(80.88%),P<0.01。与治疗前比较,两组患者治疗后左室射血分数(LVEF)均升高,左室舒张末期容积(LEDV)、左室收缩末期容积(LESV)、B型利钠肽(BNP)均降低P<0.05。治疗后,联合组LVEF较对照组升高,LEDV、LESV、BNP较对照组降低(P<0.05)。结论:小剂量多巴胺联合托伐普坦治疗顽固性心力衰竭的临床效果较好,能有效提升患者心功能,改善临床症状,缓解心力衰竭症状。

Objective To analyze the clinical effect of low-dose dopamine combined with tolvaptan for refractory heart failure.Methods A total of 150 refractory heart failure patients admitted to Central Hospital of Jiaozuo Coal Industry Group from January 2017 to December 2019 were selected,and divided into the control group(68 cases)and combination group(82 cases)according to different medication methods.The control group was given routine treatment according to individual needs,at the same time,the patients were treated with tolvaptan;the combined group was given small dose of dopamine on the basis of the control group.The clinical efficacy and changes of cardiac function indexes before and after treatment were compared between the two groups.Results No death occurred during the treatment.The total effective rate of the combined group(97.56%)was higher than that of the control group(80.88%),P<0.01.Compared with before treatment,left ventricular ejection fraction(LVEF)increased in both groups after treatment;the left ventricular end diastolic volume(LEDV),left ventricular end systolic volume(LESV),and B-natriuretic peptide(BNP)were all decreased,the difference was statistically significant(P<0.05).After treatment,the LVEF in the combined group was higher than that in the control group,and LEDV,LESV,and BNP were lower than those in the control group(P<0.05).Conclusions Low-dose dopamine combined with tolvaptan has a good clinical effect in the treatment of refractory heart failure,which can effectively improve the patient's heart function and clinical symptoms,and relieve the symptoms of heart failure.