多巴胺联合左西孟旦、硝普钠治疗老年重症心衰患者的疗效及安全性分析

Analysis of the Efficacy and Safety of Dopamine Combined with Levosimendan and Sodium Nitroprusside in the Treatment of Elderly Patients with Severe Heart Failure

目的分析老年重症心衰患者临床治疗中采取多巴胺、左西孟旦、硝普钠联合治疗的临床疗效及安全性。方法选取2020年6月—2022年1月期间北京燕化医院因重症心衰就诊的68例老年患者为研究对象。利用随机数表法分为对照组(采取硝普钠单一治疗)与研究组(采取多巴胺、左西孟旦、硝普钠联合治疗),每组34例。比较两组临床疗效及用药安全性。结果研究组治疗总有效率(91.18%)明显高于对照组(70.59%),差异有统计学意义(χ^(2)=4.660,P<0.05)。治疗后,研究组心功能指标和血清血浆标志物水平均优于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论在治疗老年重症心衰患者时采取多巴胺、左西孟旦、硝普钠联合治疗方案较单一硝普钠用药的临床疗效更好,可降低血清血浆标志物水平,改善心功能,避免发生急性心血管事件,并且联合用药后未明显增加不良反应发生风险,具有较好的用药安全性,建议推广。

Objective To analyze the clinical efficacy and safety of combined treatment with dobutamine,levosimen⁃dan and sodium nitroprusside in the clinical treatment of elderly patients with severe heart failure.Methods 68 el⁃derly patients with severe heart failure were selected from Beijing Yanhua Hospital from June 2020 to January 2022.The patients were divided into control group(treated with sodium nitroprusside alone)and study group(treated with dopamine,levosimendan and sodium nitroprusside)by random number table,with 34 cases in each group.The clinical efficacy and drug safety of the two groups were compared.Results The total effective rate of treatment in the study group(91.18%)was significantly higher than that in the control group(70.59%),and the difference was statistically significant(χ^(2)=4.660,P<0.05).After treatment,the levels of cardiac function indexes and serum plasma markers in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In the treatment of elderly patients with severe heart failure,the combination of dopamine,levo⁃simendan and sodium nitroprusside has a better clinical effect than the single sodium nitroprusside.It can reduce the level of serum plasma markers,improve cardiac function,and avoid acute cardiovascular events.Moreover,the combi⁃nation of drugs does not significantly increase the risk of adverse reactions.It has good drug safety and is recom⁃mended to promote.