Therapeutic Effect Of Early Low Dose Dopamine Combined With Furosemide On Patients With Heart Failure

Background:Diuretics are the basis of one of the drugs to treat heart failure, congestion and edema can be used in patients with heart failure, especially furosemide in the other diuretics invalid, there is still a diuretic effect. But easy in patients with chronic heart failure complicated by renal insufficiency, and as the disease progresses and other anti-heart failure drug, may cause further deterioration in renal function, resulting in the rational use of conventional diuretics such as furosemide, also appeared efficacy reduce, appear diuretic resistance, the guidelines suggest, to increase the types of diuretics and diuretic resistance while giving low-dose dopamine method can improve the diuretic effect, but patients often progress and worsening of heart failure symptoms, affect the prognosis. In this study, by the early use of small doses of dopamine plus furosemide treatment Ⅲ～Ⅳ grade of cardiac function in heart failure, and to observe its effectiveness and safety.Objective:To observe the clinical efficacy of early low dose of dopamine combined with furosemide in treatment of patients with NYHA class Ⅲ or Ⅳ heart failure. Methods:A total of124patients with Newyork Heart Association (NYHA) class III or class IV were enrolled in the present study and were randomized into two groups. Combining dopamine group included62patients who were given low dose of dopamine (0.5-1μg-kg-1-min-1) combined with intravenous furosemide (20-40mg/d); furosemide group included62patients who received furosemide (20-40mg/d). Days of hospitalization, the incidence of diuretic resistance, dialysis, worsening of renal failure and causes of death were observed. Patients were observed the days of hospitalization (ie, heart failure to improve the time required), and heart function improvement, diuretic resistance, deterioration of renal function, death, and serum potassium, serum sodium, blood pressure, heart rate, weight loss, EF values, BNP composition.Results:Days of hospitalization were5.75±1.30and8.12±1.11(P<0.05) in the dopamine group and furosemide group, respectively. Weight loss, BNP decreased (P<0.05) and LVEF rised significantly compared with the control group (P<0.05). Two cases from the dopamine group and six cases from the furosemide group needed ultrafiltration or hemodialysis (P<0.05). No mortality in the dopamine group, one patients died in the furosemide group (P>0.05).Conclusion:Early low dose dopamine combined with furosemide usage in patients with NYHA class III or IV heart failure is more effective than single use of furosemide.