呋塞米联合小剂量多巴胺治疗心衰合并肾功能不全的临床效果及对患者心、肾功能的影响

Clinical effect of furosemide combined with small-dose dopamine in the treatment of heart failure with renal insufficiency and its influences on cardiac and renal function of patients

目的分析呋塞米联合小剂量多巴胺治疗心衰合并肾功能不全的临床效果及对患者心功能和肾功能的影响。方法选取2020年1月至2021年6月本院心内科收治的90例心衰合并肾功能不全患者,采用随机数字表法将其分为对照组和观察组,每组45例。对照组在常规治疗基础上给予呋塞米治疗,观察组在对照组的基础上给予小剂量多巴胺治疗。比较两组的临床疗效、心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、血清N末端脑钠肽前体(NT-proBNP)]、肾功能指标[血尿素氮(BUN)、血清肌酐(Scr)、胱抑素C(CysC)]及不良反应发生情况。结果观察组的治疗总有效率为88.89%,明显高于对照组的68.89%,差异具有统计学意义(P<0.05)。治疗前,两组的LVEDD、LVEF和血清NT-proBNP水平比较,差异无统计学意义(P>0.05);治疗后,两组的LVEDD明显缩小,LVEF明显升高,血清NT-proBNP水平明显降低,差异均具有统计学意义(P<0.05);治疗后,观察组的LVEDD明显小于对照组,LVEF明显高于对照组,血清NT-proBNP水平明显低于对照组,差异均具有统计学意义(P<0.05)。治疗前,两组的BUN、Scr、CysC水平比较,差异无统计学意义(P>0.05);治疗后,两组的BUN、Scr、CysC水平均明显降低,差异均具有统计学意义(P<0.05);治疗后,观察组的BUN、Scr、CysC水平均明显低于对照组,差异均具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论呋塞米联合小剂量多巴胺治疗心衰合并肾功能不全的临床效果显著,能够有效改善患者的心功能和肾功能,安全性较高,值得临床推广和应用。

Objective To analyze the clinical effect of furosemide combined with small-dose dopamine in the treatment of heart failure with renal insufficiency and its influences on cardiac function and renal function.Methods A total of 90patients with heart failure with renal insufficiency admitted in the cardiology department of our hospital from January 2020to June 2021 were selected and divided into control group and observation group according to random number table method,with 45 cases in each group.The control group was treated with furosemide on the basis of conventional treatment,and the observation group was treated with small-dose dopamine on the basis of the control group.The clinical efficacy,cardiac function indexes[left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),serum N-terminal pro-brain natriuretic peptide(NT-proBNP)],renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(CysC)]and incidence condition of adverse reaction were compared between the two groups.Results The total effective rate of treatment in the observation group was 88.89%,which was significantly higher than68.89%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in LVEDD,LVEF and serum NT-proBNP level between the two groups(P>0.05);after treatment,LVEDD significantly reduced,LVEF significantly increased,and serum NT-proBNP level significantly decreased in the two groups,and the differences were statistically significant(P<0.05);after treatment,LVEDD in the observation group was significantly smaller than that in the control group,LVEF was significantly higher than that in the control group,and serum NT-proBNP level was significantly lower than that in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in BUN,Scr and CysC levels between the two groups(P>0.05);after treatment,the levels of BUN,Scr and CysC in the two groups significantly decreased,and the differences were statistically significant(P<0.05);after treatment,the levels of BUN,Scr and CysC in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Furosemide combined with small-dose dopamine in the treatment of heart failure with renal insufficiency has a significant clinical effect,it can effectively improve the cardiac function and renal function of patients,with high safety,which is worthy of clinical promotion and appication.