CAJ | 학술논문

目的：观察早期应用小剂量多巴胺联合呋塞米治疗Ⅲ~Ⅳ级心力衰竭（CHF）的疗效。方法将138例CHF患者随机分为观察组(70例，采用小剂量多巴胺联合呋塞米治疗)和对照组(68例，采用呋塞米治疗)。比较两组治疗后心功能改善情况、住院治疗时间、利尿剂抵抗情况、肾功能恶化及死亡病例数及治疗后血钾、血钠、B型脑钠肽等。结果观察组心功能改善总有效率高于对照组，其差异有统计学意义(P＜0.05)。观察组住院治疗时间、利尿剂抵抗及肾功能恶化比例均低于对照组，其差异均有统计学意义(P＜0.05)；两组死亡率比较差异无统计学意义(P＞0.05)。两组血钠、血钾水平比较差异无统计学意义(P＞0.05)；观察组B型脑钠肽含量低于对照组，且差异有统计学意义(P＜0.05)。结论早期小剂量多巴胺联合利尿剂呋塞米治疗Ⅲ~Ⅳ级心力衰竭患者疗效安全可靠，能够明显减少利尿剂抵抗，可有效改善患者的预后，具有重要的临床应用价值。
목적：관찰조기응용소제량다파알연합부새미치료Ⅲ~Ⅳ급심력쇠갈（CHF）적료효。방법장138례CHF환자수궤분위관찰조(70례，채용소제량다파알연합부새미치료)화대조조(68례，채용부새미치료)。비교량조치료후심공능개선정황、주원치료시간、이뇨제저항정황、신공능악화급사망병례수급치료후혈갑、혈납、B형뇌납태등。결과관찰조심공능개선총유효솔고우대조조，기차이유통계학의의(P＜0.05)。관찰조주원치료시간、이뇨제저항급신공능악화비례균저우대조조，기차이균유통계학의의(P＜0.05)；량조사망솔비교차이무통계학의의(P＞0.05)。량조혈납、혈갑수평비교차이무통계학의의(P＞0.05)；관찰조B형뇌납태함량저우대조조，차차이유통계학의의(P＜0.05)。결론조기소제량다파알연합이뇨제부새미치료Ⅲ~Ⅳ급심력쇠갈환자료효안전가고，능구명현감소이뇨제저항，가유효개선환자적예후，구유중요적림상응용개치。
Objective To explore the efficacy and safety of early application of low-dose dopamine combin-ing furosemide for the treatment of patients with grade Ⅲ~Ⅳ heart failure. Methods 138 cases of CHF patients were randomly divided into observation group (70 cases, low-dose dopamine combining furosemide therapy) and con-trol group (68 cases, furosemide therapy). After the treatment, the improvement of cardiac function, hospitalization time, diuretic resistance, deterioration of renal function, number of death, serum potassium, serum sodium and B-type natriuretic peptide in each group were compared. Results The total efficiency of the improvement of cardiac func-tion of the observation group was higher than that of the control group (P<0.05). The hospitalization time, the propor-tion of diuretic resistance and the renal function deterioration of the observation group were lower than that of the con-trol group (P<0.05). There were no statistically significant difference between the two groups at the mortality rate, the serum sodium level and the serum potassium level (P>0.05). The B type natriuretic peptide level of the observation group were lower than that of the control group (P<0.05). Conclusion Early low-dose dopamine combining diuretic furosemide for the treatment of grade III~IV heart failure patients was safe and reliable, which could significantly re-duce the diuretic resistance and effectively improve the prognosis of patients.