本文選題：納洛酮注射液 + 急性左心衰竭　； 參考：《中國臨床藥理學(xué)雜志》2017年07期

【摘要】：目的觀察納洛酮注射液治療急性左心衰竭的臨床療效和安全性。方法將60例急性左心衰竭患者隨機(jī)分為對照組30例和試驗(yàn)組30例。對照組予以強(qiáng)心、利尿、吸氧、抗感染等常規(guī)抗心力衰竭治療;試驗(yàn)組在對照組治療的基礎(chǔ)上,予以納洛酮靜脈注射治療納洛酮首劑0.8 mg,繼以納洛酮1.2 mg,qd,靜脈滴注,必要時在首次靜脈輸液2~4 h后增加0.8 mg,納洛酮治療3 d。2組均治療至患者左心衰竭癥狀緩解。觀察2組患者的臨床療效、β內(nèi)啡肽(β-EP)、B型腦鈉肽(BNP)、心肌肌鈣蛋白Ⅰ(cTn-Ⅰ)水平、每搏輸出量(SV)及左心室射血分?jǐn)?shù)(LVEF)變化,以及藥物不良反應(yīng)的發(fā)生情況。結(jié)果治療后,試驗(yàn)組和對照組的有效率分別為90.00%(27/30例)和63.33%(19/30例),差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后24,48,72 h,試驗(yàn)組的β-EP分別為(40.07±7.25),(31.31±6.57),(25.82±5.44)ng·L~(-1),對照組的β-EP分別為(53.78±5.98),(48.74±5.94),(41.68±6.65)ng·L~(-1),差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后24h,試驗(yàn)組和對照組的BNP分別為(216.68±39.40),(312.20±51.47)ng·L~(-1);cTn-Ⅰ分別為(0.09±0.04),(0.19±0.03)μg·L~(-1);SV分別為(83.58±5.66),(74.63±6.61)mL;LVEF分別為(50.04±6.36)%,(41.02±5.81)%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組出現(xiàn)嘔吐1例,對照組未發(fā)生藥物不良反應(yīng),試驗(yàn)組和對照組的藥物不良反應(yīng)發(fā)生率分別為3.33%和0,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論納洛酮注射液治療急性左心衰竭的臨床療效顯著,能明顯降低患者的β-EP水平,改善心肌損傷狀態(tài)和心臟功能,且安全性較好。
[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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