多巴胺持续泵入联合曲美他嗪治疗老年顽固性心衰

Continuous dopamine infusion combined with trimetazidine for the treatment of refractory heart failure in the elderly

目的分析多巴胺持续泵入联合曲美他嗪在老年顽固性心衰中的应用效果及对患者炎症指标的影响。方法选取2023年1月至2024年1月我院收治的老年顽固性心衰患者86例,随机数字表法将患者分为对照组及研究组,各43例,对照组行曲美他嗪治疗,研究组在对照组基础上给予患者多巴胺持续泵入治疗,分析两组患者心功能、心肌损伤标志物、炎症指标、不良反应以及治疗有效率。结果治疗后,两组患者心功能指标均得到改善,并且与对照组相比,研究组左心室舒张期末直径(Left ventricular end-diastolic diameter,LVEDD)、左室舒张末期内径(Left ventricular end-diastolic diameter,LVESD)下降程度较大,且左室射血分数(Left ventricular ejection fraction,LVEF)上升程度较大,统计学具有差异性(P<0.05);治疗后两组患者心肌损伤标志物水平均得到改善,且与对照组相比,研究组脑钠肽(B-type Natriuretic Peptide,BNP)、肌钙蛋白I(cardiac troponin I,cTnl)、心肌肌钙蛋白T(Cardiac troponin I,cTnT)水平下降程度较大,统计学具有差异性(P<0.05);治疗后,两组患者炎症因子均有所下降,且与对照组相比,研究组肿瘤坏死因子(tumor necrosis facto-α,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)水平较低,统计学具有差异性(P<0.05);研究组患者不良反应发生率略高,两组相比无统计学差异(P>0.05);相较于对照组,研究组治疗总有效率较高(P<0.05)。结论给予老年顽固性心衰患者多巴胺持续泵入联合曲美他嗪治疗,能够有效改善患者心功能,缓解心肌损伤,抑制机体炎症情况,起到较好的临床治疗效果。

Objective To analyze the application effect of continuous dopamine infusion combined with trimetazidine in elderly patients with refractory heart failure and its impact on inflammatory markers.Methods A total of 86 elderly patients with refractory heart failure treated at our hospital from January 2023 to January 2024 were selected,and the patients were divided into control group and study group,with 43 cases in each group.The control group received trimetazidine treatment,while the study group received continuous dopamine infusion in addition to the control treatment.The heart function,myocardial injury markers,inflammatory indicators,adverse reactions,and effective treatment rates were analyzed for both groups.Results After treatment,both groups showed improvement in heart function indicators and compared with the control group,the study group demonstrated a greater reduction in left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD),as well as a greater increase in left ventricular ejection fraction(LVEF),with statistically significant differences(P<0.05).Both groups showed improvements in myocardial injury markers,but the study group had a more significant decrease in levels of B-type natriuretic peptide(BNP),cardiac troponin I(cTnI),and cardiac troponin T(cTnT)compared to the control group(P<0.05).After treatment,the inflammatory markers in both groups decreased,and compared with the control group,the tumor necrosis factor(TNF-α)and hypersensitive C-reactive protein(hs-CRP)were lower(P<0.05).The incidence of adverse reactions was slightly higher in the study group,but there was no statistical difference between the two groups(P>0.05).Compared with the control group,the total effective rate of treatment in the study group was higher(P<0.05).Conclusion Continuous dopamine infusion combined with trimetazidine treatment can effectively improve heart function,alleviate myocardial injury,and suppress inflammation in elderly patients with refractory heart failure,resulting in favorable clinical outcomes.