摘要
目的:评价右美托咪定抗交感活性在急性左心衰中的应用。方法:137例急性左心衰患者被分为常规治疗组(44例)、美托洛尔组(47例)、右美托咪定组(46例),测定血浆去甲肾上腺素(NE)、肾上腺素、血浆脑型利钠肽(BNP)并行脉搏指示连续心输出量监测(PiCCO),监测心输出量(CO)、心指数(CI)、血管外肺水指数(EVLWI)等评估心功能状态。结果:治疗3d后,与常规治疗组相比,右美托咪定组血浆NE[(4.51±0.24)nmol/L比(3.61±0.31)nmol/L]、肾上腺素[(3.23±0.51)nmol/L比(2.19±0.29)nmol/L],EVLWI[(9.96±0.78)ml/kg比(7.16±0.11)ml/kg],BNP[(4783.59±79.33)pg/ml比(3126.88±58.72)pg/ml]水平均显著下降(P均<0.05);CO[(3.09±0.14)L·min-1·m-2比(4.03±0.25)L·min-1·m-2]、CI[(1.28±0.14)比(1.89±0.14)]均显著上升(P均<0.05),但与美托洛尔组比较无显著差异(P均>0.05)。结论:右美托咪定可有效抑制交感活性,有效改善心功能。
Objective： To evaluate effect of anti-sympathetic activity of dexmedetomidine in acute left heart failure. Methods： A total of 137 cases with acute left heart failure were randomly divided into routine treatment group （n = 44）, metoprolol group （n = 47） and dexmedetomidine group （n = 46）. Plasma levels of norepinephrine （NE）, epi-nephrine and brain natriuretic peptide （BNP） were measured. Pulse-indicated continuous cardiac output （PiCCO） monitoring was performed to monitor cardiac output （CO）, cardiac index （CI） and extravascular lung water index （EVLWI） in order to evaluate cardiac function status. Results： Compared with routine treatment group 3d after treatment, there were significant decrease in plasma levels of NE [ （4. 51 ± 0.24） nmol/L vs. （3.61 ± 0. 31） nmol/ L], epinephrine [（3.23 ± 0.51） nmol/L vs. （2.19 ± 0.29） nmol/L], BNP [ （4783.59 ± 79.33） pg/ml vs. （3126.88± 58.72） pg/ml ] and EVLWI [ （9.96± 0.78） ml/kg vs. （7.16± 0.11） ml/kg], P〈0.05 all; and there were significant increase in CO [ （3.09-±0.14） L·min^-1·m^-2 vs. （4. 03-±0.25） L·min^-1·m^-2], CI [ （1.28 ± 0.14） vs. （1.89 ± 0.14）] （P〈0.05 all） in dexmedetomidine group. There were no significant differences in a- bove hemodynamic indexes between dexmedetomidine group and metoprolol group, P 〉 0. 05 all. Conclusion.. Dexmedetomidine can effectively inhibit sympathetic activity and improved heart function.
出处
《心血管康复医学杂志》
CAS
2013年第5期508-511,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心力衰竭
充血性
药理学
右美托咪定
Heart failure, congestive
Pharmacology
Dexmedetomidine
