多巴酚丁胺联合胺碘酮在ICU心律失常患者中应用及对相关蛋白影响

摘要 目的：探讨ICU心律失常患者在临床治疗中，应用多巴酚丁胺联合胺碘酮这一治疗方案进行治疗的效果。方法：抽取我院2019年4月至2022年5月收治的72例ICU中发生心律失常的患者，以平均法分为对照组和实验组，各36例，对照组予以多巴酚丁胺治疗，实验组应用多巴酚丁胺+胺碘酮治疗，对比两组心功能指标、BNP和hs-CRP水平、心律失常发生次数、平均心率、临床疗效、不良心血管事件发生情况及药物安全性。结果：治疗前两组患者的LVEF、LVEDD、LVESD水平无差异（P＞0.05），治疗后两组患者的LVEF水平升高，LVEDD、LVESD水平均降低，并且治疗后实验组患者的以上指标变化幅度大于对照组（P＞0.05）；治疗前两组患者的BNP、hs-CRP水平无差异（P＞0.05），治疗后两组水平均降低，并且治疗后实验组BNP、hs-CRP水平均较对照组低（P＞0.05）；治疗前两组患者的心律失常发生次数及平均心率无差异（P＞0.05），治疗后两组患者的心律失常发生次数及平均心率均降低，并且治疗后实验组心律失常发生次数较对照组少，平均心率较对照组低（P＞0.05）；实验组患者临床治疗有效率为94.44 %，对照组患者的临床治疗有效率为69.44 %，实验组患者临床治疗有效率高于对照组（P＞0.05）；实验组不良心血管事件发生率和不良反应发生率均较对照组低（P＞0.05）。结论：多巴酚丁胺联合胺碘酮对改善ICU心律失常患者心功能，减少心律失常次数，稳定心率，降低脑钠肽水平和超敏C反应蛋白水平有显著的治疗效果，且患者在治疗后发生的不良心血管事件及药物不良反应少，有着令人满意的药物安全性。

Application of Dobutamine Combined with Amiodarone in Patients with Arrhythmia in ICU and Its Eeffect on Related Proteins

ABSTRACT Objective: To explore the effect of dobutamine combined with amiodarone in the clinical treatment of arrhythmia patients in ICU. Methods: 72 patients with arrhythmias in ICU treated in our hospital from April 2019 to may 2022 were divided into matched group and experimental group by average method, with 36 cases in each group. The matched group was treated with dobutamine, while the experimental group was treated with dobutamine + amiodarone. The cardiac function indexes, BNP and HS CRP levels, the frequency of arrhythmias, average heart rate, clinical efficacy, adverse cardiovascular events and drug safety were compared between the two groups. Results: There was no difference in the levels of LVEF, LVEDd and LVESD between the two groups before treatment (P>0.05). After treatment, the levels of LVEF increased and the levels of LVEDd and LVESD decreased in the two groups. After treatment, the changes of the above indexes in the experimental group were greater than those in the matched group(P<0.05); Before treatment, there was no difference in the levels of BNP and hs CRP between the two groups (P>0.05). After treatment, the levels of BNP and hs CRP in the two groups decreased, and after treatment, the levels of BNP and hs CRP in the experimental group were lower than those in the matched group (P<0.05); Before treatment, there was no difference in the number of arrhythmias and average heart rate between the two groups (P>0.05). After treatment, the number of arrhythmias and average heart rate in the two groups decreased, and after treatment, the number of arrhythmias in the experimental group was less than that in the matched group, and the average heart rate was lower than that in the matched group(P<0.05); The effective rate of clinical treatment in the experimental group was 94.44 %, and that in the matched group was 69.44 %. The effective rate of clinical treatment in the experimental group was higher than that in the matched group (P<0.05); The incidence of adverse cardiovascular events and adverse reactions in the experimental group were lower than those in the matched group (P<0.05). Conclusion: Dobutamine combined with amiodarone has a significant therapeutic effect on improving cardiac function in ICU arrhythmia patients, reducing the number of arrhythmias, stabilizing heart rate, and reducing the level of brain natriuretic peptide and high-sensitivity C-reactive protein, and the patient develops after treatment. There are few adverse cardiovascular events and adverse drug reactions, and it has a satisfactory drug safety.