注射用硝普钠联合托拉塞米注射液与硝酸甘油注射液联合呋塞米注射液治疗老年慢性心力衰竭临床疗效的对比研究

摘要

目的 比较注射用硝普钠联合托拉塞米注射液与硝酸甘油注射液联合呋塞米注射液治疗老年慢性心力衰竭的临床疗效.方法 选取2015年3月-2016年3月辽阳市中心医院收治的老年慢性心力衰竭患者124例,采用随机数字表法分为对照组和试验组,每组62例.在常规治疗基础上,对照组患者给予硝酸甘油注射液联合呋塞米注射液治疗,试验组患者给予注射用硝普钠联合托拉塞米注射液治疗;两组患者均连续治疗5 d.比较两组患者临床疗效,治疗前后收缩压、舒张压、血钾及血清心型脂肪酸结合蛋白(H-FABP)、可溶性ST2蛋白(sST2)水平,并观察两组患者治疗期间不良反应发生情况.结果 试验组患者临床疗效优于对照组(P<0.05).治疗前两组患者收缩压、舒张压、血钾比较,差异无统计学意义(P>0.05);治疗后试验组患者收缩压、舒张压、血钾高于对照组(P<0.05).治疗前两组患者血清H-FABP、sST2水平比较,差异无统计学意义(P>0.05);治疗后试验组患者血清H-FABP、sST2水平低于对照组(P<0.05).两组患者治疗期间均未出现严重不良反应.结论 注射用硝普钠联合托拉塞米注射液治疗老年慢性心力衰竭的临床疗效优于硝酸甘油注射液联合呋塞米注射液,可有效降低血清H-FABP、sST2水平,保护心肌细胞,对血压和血钾影响较小,且安全性较高.%Objective To compare the clinical effect in treating elderly patients with chronic heart failure between sodium nitroprusside for injection combined with torasemide injection and nitroglycerin injection combined with furosemide injection.Methods A total of 124 elderly patients with chronic heart failure were selected in the Central Hospital of Liaoyang from March 2015 to March 2016,and they were divided into control group and test group according to random number table,each of 62 cases.Based on conventional treatment,patients of control group received nitroglycerin injection combined with furosemide injection,while patients of test group received sodium nitroprusside for injection combined with torasemide injection;both groups continuously treated for 5 days.Clinical effect,systolic blood pressure,diastolic blood pressure,serum kalium,serum levels of H-FABP and sST2 before and after treatment were compared between the two groups,and incidence of adverse reactions was observed during the treatment.Results Clinical effect of test group was statistically significantly better than that of control group(P<0.05).No statistically significant differences of systolic blood pressure,diastolic blood pressure or serum kalium was found between the two groups before treatment(P>0.05),while systolic blood pressure,diastolic blood pressure and serum kalium of test group were statistically significantly higher than those of control group after treatment(P<0.05).No statistically significant differences of serum level of H-FABP or sST2 was found between the two groups before treatment(P>0.05),while serum levels of H-FABP and sST2 of test group were statistically significantly lower than those of control group after treatment(P<0.05).No one of the two group occurred any serious adverse reactions during the treatment.Conclusion Sodium nitroprusside for injection combined with torasemide injection has better clinical effect than nitroglycerin injection combined with furosemide injection in treating elderly patients with chronic heart failure,can reduce the serum levels of H-FABP and sST2,protect the myocardial cell,has little effect on blood pressure and blood potassiam,and is relatively safe.