纳洛酮注射液治疗急性左心衰竭的临床研究

发布时间：2018-06-26 10:35

  本文选题：纳洛酮注射液 + 急性左心衰竭　； 参考：《中国临床药理学杂志》2017年07期

【摘要】：目的观察纳洛酮注射液治疗急性左心衰竭的临床疗效和安全性。方法将60例急性左心衰竭患者随机分为对照组30例和试验组30例。对照组予以强心、利尿、吸氧、抗感染等常规抗心力衰竭治疗;试验组在对照组治疗的基础上,予以纳洛酮静脉注射治疗纳洛酮首剂0.8 mg,继以纳洛酮1.2 mg,qd,静脉滴注,必要时在首次静脉输液2~4 h后增加0.8 mg,纳洛酮治疗3 d。2组均治疗至患者左心衰竭症状缓解。观察2组患者的临床疗效、β内啡肽(β-EP)、B型脑钠肽(BNP)、心肌肌钙蛋白Ⅰ(cTn-Ⅰ)水平、每搏输出量(SV)及左心室射血分数(LVEF)变化,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的有效率分别为90.00%(27/30例)和63.33%(19/30例),差异有统计学意义(P0.05)。治疗后24,48,72 h,试验组的β-EP分别为(40.07±7.25),(31.31±6.57),(25.82±5.44)ng·L~(-1),对照组的β-EP分别为(53.78±5.98),(48.74±5.94),(41.68±6.65)ng·L~(-1),差异均有统计学意义(P0.05)。治疗后24h,试验组和对照组的BNP分别为(216.68±39.40),(312.20±51.47)ng·L~(-1);cTn-Ⅰ分别为(0.09±0.04),(0.19±0.03)μg·L~(-1);SV分别为(83.58±5.66),(74.63±6.61)mL;LVEF分别为(50.04±6.36)%,(41.02±5.81)%,差异均有统计学意义(P0.05)。试验组出现呕吐1例,对照组未发生药物不良反应,试验组和对照组的药物不良反应发生率分别为3.33%和0,差异无统计学意义(P0.05)。结论纳洛酮注射液治疗急性左心衰竭的临床疗效显著,能明显降低患者的β-EP水平,改善心肌损伤状态和心脏功能,且安全性较好。
[Abstract]:Objective to observe the clinical efficacy and safety of naloxone injection in the treatment of acute left ventricular failure. Methods 60 patients with acute left ventricular failure were randomly divided into control group (n = 30) and experimental group (n = 30). The control group was treated with cardioversion, diuretic, oxygen inhalation, anti-infection and other routine anti-heart failure therapy, while the experimental group was treated with naloxone by intravenous injection of 0.8 mg of naloxone on the basis of the treatment in the control group, followed by intravenous drip of naloxone 1.2 mg / g QD. When necessary, 0.8 mg was increased 4 hours after the first intravenous infusion. All patients in naloxone group were treated with Naloxone for 3 days until the symptoms of left ventricular failure were relieved. The clinical efficacy, 尾 -endorphin (尾 -EP) type B brain natriuretic peptide (BNP), cardiac troponin 鈪，

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