硝普钠与硝酸甘油治疗重症心力衰竭的效果比较

Comparison of effects of sodium nitroprusside and nitroglycerin in the treatment of severe heart failure

目的比较硝普钠与硝酸甘油治疗重症心衰的临床效果。方法选择2019年1月至2020年12月我院收治的90例重症心衰患者为本次研究对象,根据临床用药差异将其分为硝酸甘油组(45例,硝酸甘油治疗)和硝普钠组(45例,硝普钠治疗)。比较两组的治疗效果。结果治疗前,两组的B型脑钠肽(BNP)、心肌肌钙蛋白T(cTnT)、可溶性ST2蛋白(sST2)、乳酸(LA)水平比较,差异无统计学意义(P>0.05);治疗后,硝普钠组的BNP、cTnT、sST2、LA水平低于硝酸甘油组(P<0.05)。治疗前,两组的左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室收缩期末容积(LVESV)、左心室舒张期末容积(LVEDV)比较,差异无统计学意义(P>0.05);治疗后,硝普钠组的LVEF高于硝酸甘油组,LVESD、LVESV、LVEDV低于硝酸甘油组(P<0.05)。硝普钠组的不良反应总发生率低于硝酸甘油组(P<0.05)。治疗后,硝普钠组的身体领域、情绪领域、其他领域评分低于硝酸甘油组(P<0.05)。结论相较于硝酸甘油硝,硝普钠治疗重症心衰的临床应用价值更高,值得临床应用。

Objective To compare the clinical effects of sodium nitroprusside and nitroglycerin in the treatment of severe heart failure.Methods Ninety patients with severe heart failure admitted in our hospital from January 2019 to December 2020 were selected as the objects of this study.According to the difference of clinical medication,the patients were divided into nitroglycerin group(45 cases,nitroglycerin treatment)and sodium nitroprusside group(45 cases,sodium nitroprusside treatment).The therapeutic effects of the two groups were compared.Results Before treatment,there were no significant differences in the levels of brain natriuretic peptide(BNP),cardiac troponin T(cTnT),soluble ST2 protein(sST2)and lactic acid(LA)between the two groups(P>0.05);after treatment,the levels of BNP,cTnT,sST2 and LA in the sodium nitroprusside group were lower than those in the nitroglycerin group(P<0.05).Before treatment,there were no statistically significant differences in left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV)between the two groups(P>0.05);after treatment,the LVEF in the sodium nitroprusside group was higher than that in the nitroglycerin group,and the LVESD,LVESV and LVEDV were lower than those in the nitroglycerin group(P<0.05).The total incidence of adverse reactions in the sodium nitroprusside group was lower than that in the nitroglycerin group(P<0.05).After treatment,the scores of physical field,emotional field and other fields in the sodium nitroprusside group were lower than those in the nitroglycerin group(P<0.05).Conclusion Compared with nitroglycerin,sodium nitroprusside has higher clinical value in the treatment of severe heart failure,which is worthy of clinical application.