米力农、多巴胺及呋塞米联合治疗难治性心衰的疗效观察

摘要

Objective To explore the clinical efficacy and safety of milrinone,dopamine and furosemide in the treatment of refractory heart failure (HF).Methods One hundred and four patients with refractory heart failure were randomly divided into two groups:con-trol group (n=52)treated with routine treatment,and treatment group (n=52)treated with milrinone,dopamine and furosemide in the basis of routine treatment for 7 days.The changes of 6-min walk distance (6MWD),cardiac output (CO),left ventricular ejection fraction (LVEF),left ventricular end diastolic diameter (LVEDD),brain natriuretic peptide (BNP)were observed in two groups before and after treatment.The clinical efficacy and adverse reactions were observed.Results The 6MWD,CO,LVEF,LVEDD,BNP were improved after treatment in two groups,which was better in treatment group than that in control group (P<0.05).The total clinical ef-fective rate was 80.8% in treatment group,which was significantly higher than that in control group(63.4%,P<0.05).There was no significant difference in the adverse reactions between two groups (P>0.05).Conclusion Milrinone,dopamine and furosemide can improve the heart function,al eviate the clinical symptoms in patients with refractory heart failure.%目的 探讨米力农、多巴胺及呋塞米(速尿)联合治疗难治性心衰的临床疗效及安全性.方法 将104例难治性心衰病人随机分成对照组与观察组,每组52例.两组病人均给予吸氧、抗感染、利尿剂、硝酸酯类药物及血管紧张素转换酶抑制剂等常规治疗,对照组在常规治疗的基础上给予速尿及地高辛治疗,观察组在常规治疗的基础上给予米力农、多巴胺及速尿联合治疗,两组疗程均为1周.观察两组病人治疗前后6 min步行距离、每搏输出量(CO)、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、脑钠肽(BNP)等指标的变化及不良反应情况.结果 两组病人治疗后6 min步行距离、CO、LVEF、LVEDD、BNP较治疗前均明显改善,且观察组各指标的改善情况显著优于对照组,差异均有统计学意义(P<0.05);观察组治疗总有效率为80.8%,显著高于对照组的63.4%,差异有统计学意义(P<0.05);两组病人治疗期间不良反应发生率比较差异无统计学意义(P>0.05).结论 米力农、多巴胺及速尿联合治疗难治性心衰可有效改善病人的心功能,缓解其临床症状,并且疗效显著、安全可靠.