硝普钠联合多巴胺治疗低血压合并慢性心力衰竭的疗效及对血浆Nt_医学论文.docVIP

硝普钠联合多巴胺治疗低血压合并慢性心力衰竭的疗效及对血浆Nt_医学论文 硝普钠联合多巴胺治疗低血压合并慢性心力衰竭的疗效及对血浆Nt_医学论文 【关键词】 心力衰竭；硝普钠；多巴胺；氨基末端脑钠肽 　　［摘要］ 目的 观察硝普钠，多巴胺与利尿剂合用治疗低血压合并慢性充血性心力衰竭（心衰）的疗效及安全性，及其对患者血浆氨基末端脑钠肽（NtproBNP）浓度的影响。方法 将心功能Ⅲ～Ⅳ级的105例心衰患者，随机分为治疗组和对照组，对照组给予利尿剂与氨茶碱治疗；治疗组在对照组基础上加用硝普钠与多巴胺，治疗观察10天，并对两组的心功能改善评价、症状改善及心脏彩超进行对比，并采用ELISA法对两组患者治疗前后血浆NtproBNP进行测定。结果 治疗组总有效率，显效率，治疗后左室射血分数（LVEF）显著高于对照组（0.05）；治疗组治疗后血浆NtproBNP水平显著低于对照组（0.05）。结论 硝普钠与多巴胺联用在治疗低血压合并慢性充血性心衰中有重要意义，血浆NtproBNP水平在心衰治疗疗效评价中有较高敏感性。 　　［关键词］ 心力衰竭；硝普钠；多巴胺；氨基末端脑钠肽 　　Effects of combination of sodium nitroprusside， dopaine in the treatment of chronic congestive heart failure and effects on plasma NtproBNP level 　　［Abstract］ Objective To detect the effect and safety of combination of sodium nitroprusside， dopamine in the treatment of chronic heart failure， and the effect on the level of plasma NtproBNP.Methods 105 patients with heart failure of 3～4 degree of heart function were divided into treatment group and control group randomly.The control group was treated with diuretic and aminophylline.And the treatment group was treated with sodium nitroprusside， dopaine additionally.The treatment was last 10 days.Comparison was done between the two groups， as the evaluation of improvement of heart function， improvement of signs of heart failure，the change of left ventricular ejection fraction (LVEF) and left ventricular enddiastolic diameter（LVDd） by ultrasonography of heart as the evaluation index， and the level of plasma NtproBNP was measured before and after the treatment in each group.Results The total utility rate，total of significant utility rate，left ventricular ejection fraction (LVEF) in treatment group were significantly higher than those in control group after treatment（0.05）.And the plasma NtproBNP level was significantly lower than that in control group (Pgt0.05).Conclusion Effects of combination of sodium nitroprusside， dopaine in the treatment of low blood pressure with chronic congective heart failure was significant.Plasma NtproBNP level has