速尿联合小剂量多巴胺治疗心力衰竭伴利尿剂抵抗的疗效及安全性

Clinical efficacy and safety of furosemide combined with low-dose dopamine in the treatment of diuretic-resistant heart failure

目的观察静脉泵入呋塞米(速尿)和小剂量多巴胺治疗心力衰竭伴利尿剂抵抗的疗效及安全性。方法将我院收治的心力衰竭伴利尿剂抵抗患者60例,随机分为对照组和观察组,每组30例。两组均给予系统抗心力衰竭治疗,对照组给予速尿持续静脉泵入,观察组在对照组的基础上联合小剂量多巴胺泵入。治疗后评价两组的心功能分级改善总有效率、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、N末端B型利钠肽原(NT-proBNP)水平、24 h尿量、不良反应情况。结果观察组心功能分级改善总有效率为93.33%,对照组为66.67%,两组比较,P<0.05。两组LVEF水平较治疗前显著增加(P<0.05),LVEDD、NT-proBNP水平较治疗前均显著降低(P<0.05);治疗后两组LVEDD、LVEF水平比较,P>0.05;两组NT-proBNP水平比较,P<0.05。两组24 h尿量较治疗前均显著增加(P<0.05),且观察组利尿效果显著优于对照组(P<0.05)。两组不良反应比较,P>0.05。结论在系统抗心力衰竭治疗的基础上,速尿联合小剂量多巴胺治疗心力衰竭伴利尿剂抵抗临床效果显著,可有效改善患者临床症状和心脏功能,且安全性较高。

Objective To observe clinical efficacy and safety of furosemide combined with low-dose dopamine in the treatment of diuretic-resistant heart failure.Methods A total of 60 patients with heart failure combined with diuretic resistance were randomly divided into the control group and the observation group,30 cases in each group.Two groups were both given systemic anti-heart failure treatment.The control group were given furosemide intravenous infusion.On the basis of the control group,the observation group were given low-dose dopamine intravenous infusion.The total effective rate of heart function improvement,the left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),N-terminal pro-B-type natriuretic peptide(NT-ProBNP),24h urine volume and incidence of adverse reactions after treatment were compared between two groups.Results The total effective rate of heart function improvement in observation group was 93.33%and the control group was 66.67%,the difference between the two groups was statistically significant(P<0.05).After treatment,the LVEF in the two groups was significantly increased compared with that before treatment(P<0.05),the LVEDD and NT-proBNP were significantly decreased compared with those before treatment(P<0.05).The comparison of LVEF and LVEDD between the two groups was with P>0.05,the comparison of NT-proBNP was with P<0.05.The 24 h urine volume of the two groups was significantly increased compared with that before treatment(P<0.05),and the observation group was significantly better than that in the control group(P<0.05).There were no significant difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion On the basis of systemic anti-heart failure treatment,low-dose dopamine combined with furosemide has a significant clinical effect in the treatment of diuretic-resistant heart failure,and can effectively improve the clinical symptoms of patients with high safety.