| 朱琳,杨文静,尤立蕊,等.小剂量多巴胺 +托拉塞米治疗老年慢性心力衰竭的效果观察[J].安徽医药,2025,29(6):1260-1264. |
| 小剂量多巴胺 +托拉塞米治疗老年慢性心力衰竭的效果观察 |
| Efficacy observation of low-dose dopamine plus tolasemide in the treatment of chronic heart failure in elderly patients |
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| DOI：10.3969/j.issn.1009-6469.2025.06.041 |
| 中文关键词: 慢性心力衰竭 多巴胺 托拉塞米 老年人 肾素 -血管紧张素 -醛固酮系统 |
| 英文关键词: Chronic heart failure Dopamine Torasemil Aged |
| 基金项目: |
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| 摘要点击次数: 56 |
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| 中文摘要: |
| 目的探讨老年慢性心力衰竭病人采用小剂量多巴胺联合托拉塞米实施治疗的疗效及作用机制。方法选取 2022年 3月至 2023年 3月在北京市普仁医院和中国医科大学航空总医院实施治疗的 103例老年慢性心力衰竭病人开展临床试验，采用单盲试验设计、随机数字表法将病人分为联合组 52例、对照组 51例。对照组在基础治疗方案上加用托拉塞米治疗(将 5 mg托拉塞米注射液用 0.9%氯化钠溶液稀释后静脉滴注，每天 1次，出院后改托拉塞米片口服，每次 15 mg，维持治疗)，联合组在基础治疗及对照组方案上加用小剂量多巴胺治疗(多巴胺注射液 2~3 μg·kg.1·min.1静脉泵入)，两组病人的疗程均为 2周，对比疗效差异。结果治疗后，联合组病人的每搏量、左室射血分数( LVEF)、心指数测定值及 6 min步行距离均大于对照组，血浆 N端脑利尿钠肽前体( NT-proBNP)测定值则较对照组降低更为明显( P<0.05)；联合组治疗后的血管紧张素 Ⅱ(AngⅡ)、醛固酮、肾素与对照组比较，差异无统计学意义( P>0.05)；治疗后，联合组病人的白细胞介素 -6(IL-6)、肿瘤坏死因子 α(TNF-α)测定值低于对照组( P<0.05)；治疗后，联合组病人的显效率 61.54%(32/52)、有效率 32.69%(17/52)、无效率5.77%(3/52)，对照组显效率 41.18%(21/51)、有效率 47.06%(24/51)、无效率 11.76%(6/51)，联合组疗效优于对照组( P<0.05)。结论小剂量多巴胺 +托拉塞米治疗老年慢性心力衰竭病人效果优于基础治疗联合托拉塞米，能更有效地改善炎症反应程度、提高心功能。 |
| 英文摘要: |
| Objective To explore the efficacy and mechanism of low-dose dopamine combined with torasemide in the treatment of el-derly patients with chronic heart failure.Methods A total of 103 elderly patients with chronic heart failure who were treated in BeijingPuren Hospital and China Medical University Aviation General Hospital from March 2022 to March 2023 were selected for clinical tri-al. A simple randomized grouping and a single blind trial design method were adopted, and the patients were assigned into a combina-tion group (n=52) and a control group (n=51) with a random number table. The control group was treated with tolasemide (5 mg of to-rasemide injection was diluted with 0.9% sodium chloride solution for intravenous drip once a day, and after discharge, torasemide tab-lets were taken 15 mg each time, for maintenance treatment) in addition to the basic treatment regimen, while the combination groupwas treated with low-dose dopamine (2-3μg·kg.1·min.1 of dopamine injection was administered by intravenous pump) in addition to thebasic treatment regimen and the treatment plan of the control group. The course of treatment for both groups was 2 weeks, and the effi-cacies were compared.Results After treatment, the stroke volume (SV), left ventricular ejection fractions (LVEF), cardiac index (CI)and 6 min walking distance of patients in the combination group were higher than those in the control group, while the plasma N-termi-nal brain natriuretic peptide precursor (NT-proBNP) value was significantly lower than that in the control group, with statistical signifi-cance (P<0.05). There were no significant differences in angiotensin Ⅱ (Ang Ⅱ), aldosterone and plasma renin activity between thecombination group and the control group after treatment (P>0.05). After treatment, the measured values of interleukin-6 (IL-6) and tu-mor necrosis factor α (TNF-α) in the combination group were lower than those in the control group (P<0.05). After treatment, the signifi-cant efficiency [61.54% (32/52)], effective rate [32.69% (17/52)] and ineffective rate [5.77% (3/52)] in the combination group were bet-ter than those [41.18% (21/51), 47.06% (24/51), 11.76% (6/51)] in the control group (P<0.05).Conclusion The efficacy of low-dose dopamine plus tolasemide in the treatment of elderly patients with chronic heart failure is better than that of basic therapy combinedwith tolasemide, which can improve the degree of inflammation and cardiac function more effectively. |
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