Elis A, Bental T, Kimchi O, Ravid M, Lishner M
Department of Medicine, Meir Hospital, Kfar-Saba, Israel.
Clin Pharmacol Ther. 1998 Jun;63(6):682-5. doi: 10.1016/S0009-9236(98)90092-3.
Intravenous dobutamine administration improves short-term hemodynamics in patients with severe congestive heart failure (CHF). However, the clinical benefit of periodic administration remains controversial.
To evaluate the efficacy of intermittent dobutamine administration in patients with refractory CHF.
Nineteen patients with New York Heart Association class III/IV, ischemia-induced CHF participated in this double-blind, placebo-controlled study. All patients received intravenous dobutamine or placebo over a 24-hour period every 2 to 3 weeks for 6 months. They were also treated with angiotensin-converting enzyme inhibitors, digoxin, and diuretics. The number of admissions for CHF and mortality rate were compared.
Ten patients received dobutamine and nine received placebo. The pretreatment characteristics were similar in both groups. No statistically significant difference was observed between the number of admissions for CHF (p = 0.11). The median survival after enrollment was 7.97 months in the placebo group and 4.6 months in the dobutamine group. The Kaplan-Meier survival curves overlay, with no statistically significant difference between the treatment arms (p = 0.7).
Intermittent dobutamine infusions in patients with refractory CHF have no effect on the need for hospitalization or on survival.
静脉注射多巴酚丁胺可改善重度充血性心力衰竭（CHF）患者的短期血流动力学。然而，定期给药的临床益处仍存在争议。
评估间歇性多巴酚丁胺给药对难治性CHF患者的疗效。
19例纽约心脏协会III/IV级、缺血性CHF患者参与了这项双盲、安慰剂对照研究。所有患者每2至3周接受一次静脉注射多巴酚丁胺或安慰剂，持续24小时，共6个月。他们还接受了血管紧张素转换酶抑制剂、地高辛和利尿剂治疗。比较CHF住院次数和死亡率。
10例患者接受多巴酚丁胺治疗，9例接受安慰剂治疗。两组的预处理特征相似。CHF住院次数之间未观察到统计学显著差异（p = 0.11）。安慰剂组入组后的中位生存期为7.97个月，多巴酚丁胺组为4.6个月。Kaplan-Meier生存曲线重叠，治疗组之间无统计学显著差异（p = 0.7）。
难治性CHF患者间歇性多巴酚丁胺输注对住院需求或生存率无影响。
