硝普钠对老年人充血性心力衰竭患者心功能及NO、LPO和ANF的影响

Effects of sodium nitroprusside on cardiac function and the level of ni tric oxide, lipid peroxide and atrial natriuretic factor of the elderly patients with congestive heart failure

目的 :观察硝普钠对老年人CHF患者心功能及NO、LPO和ANF的影响。方法 :1 0 0例 60岁以上CHF患者随机分为硝普钠组和硝酸甘油组 ,硝普钠组应用硝普钠 2 0mg,5 %GS1 0 0ml静滴 ,开始剂量为 1 0～ 2 0 μg·min- 1 ,效果不佳时剂量递增 5～ 1 0 μg,最大剂量 <1 0 0 μg·min- 1 ;硝酸甘油组应用硝酸甘油2 0mg,5 %GS 1 0 0ml静滴 ,均为每日 1次 ,疗程 5～ 7d。结果 :硝普钠组总有效率为 96% ,硝酸甘油组为68% ,两组治疗后心率血压下降、LVEF及CO均增加 ,LPO、ANF下降 ,NO水平上升 ,两组比较 ,硝普钠组明显优于硝酸甘油组 ,P <0 .0 1。结论 :硝普钠对老年人CHF疗效显著 ,不良反应较少 ,对常规治疗效果不佳的老年人CHF患者 。

AIM: To observe effects of sodium nitroprusside on cardiac f unction and the level of nitric oxide (NO), lipid peroxide (LPO) and atrial natr iuretic factor (ANF) of the elderly patients with congestive heart failure (CHF) . METHODS: 100 patients with CHF who were over sixty years old were randomized to sodium nitroprusside group and nitroglycerine group. The pati ents in nitroprusside group received intravenous drip of 20 mg sodium nitropruss ide +5% GS100 ml once a day, the basic drip rate of sodium nitroprusside was 10- 20 μg·min -1 ; if the effects was bad, then the incremental increases of d rip rate was 5-10 μg·min -1 , but the basic drip rate of sodium nitropruss ide was less than 100 μg·min -1 . The patients in nitroglycerine group rec eived intravenous drip of 20 mg nitroglycerine+5% GS 100 ml once a day; the cour se of therapy in each group was 5-7 days. RESULTS: the general e ffective rate in sodium nitroprusside group was 96% ,and that in nitroglycerine group was 68%. After treatment, in each group, heart rate and blood pressure wer e decreased, LVEF and CO increased, the level of LPO and ANF were decreased, the level of NO increased; but apparently the curative effects of sodium nitropruss ide group was much better than that of nitroglycerine group (P < 0.01 ). CONCLUSION: Sodium nitroprusside has remarkable cur ative effects in elderly patients with CHF and few side effects; and the elderly patients with CHF, failed to conventional treatment, can be treated by sodium n itroprusside.