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难治性心衰在心血管疾病中较为多见，对有洋地黄中毒倾向和需慎用洋地黄者，处理尤为棘手。我们对这类病人使用小剂量多巴酚丁胺治疗、疗效尚好，现报道如下：资料与方法对象：15例难治性心衰中男性8例、女性7例，年龄25—79岁、平均56岁。其中扩张型心肌病3例、冠心病7例、风心病联合瓣膜损害5例（含二尖瓣分离术后1例），心功能均为NYHA Ⅳ级。以上病例经洋地黄制剂和/或利尿剂、血管扩张剂等常规抗心衰处理，症状（心悸、气短、少尿），体征（收缩压≤80mmHg、紫绀、肺郁血征，肝大）仍无改善。
Refractory heart failure is more common in cardiovascular disease, the tendency to have digitalis poisoning and caution with digitalis, treatment is particularly difficult. We use low-dose dobutamine for such patients, the effect is good, are reported as follows: Materials and Methods Subjects: 15 cases of refractory heart failure in 8 males and 7 females, aged 25-79 years, mean 56 years old. Among them, 3 cases of dilated cardiomyopathy, 7 cases of coronary heart disease, 5 cases of rheumatic heart disease combined with valve injury (including 1 case after mitral valve separation), and NYHA Ⅳ grade were all found in cardiac function. The above cases by digitalis preparations and / or diuretics, vasodilators and other conventional anti-heart failure treatment, symptoms (palpitations, shortness of breath, oliguria), signs (systolic blood pressure ≤ 80mmHg, cyanotic, No improvement.