左西孟旦联合西地那非治疗慢性心力衰竭肺动脉高压的疗效观察  

Efficacy of sildenafii combined with levosimendan on patients with chronic heart failure and pul-monary hypertension

作　　者：廉湘琳[1] 杨国杰[1] 王二玲[1] 

机构地区：[1]郑州大学第一附属医院老年心血管科,450052

出　　处：《中国实用医刊》2013年第19期14-16,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察左西孟旦联合西地那非治疗慢性心力衰竭合并肺动脉高压患者的疗效。方法收集2012年6月至2012年12月慢性充血性心力衰竭并肺动脉高压的住院患者30例，随机双盲将患者分为两组，治疗组15例，在常规治疗基础上使用西地那非和左西孟旦，左西孟旦注射液初始以12μg／kg，注射10min，随即以O．1μg/（kg·min），静脉点滴，持续时间24h，同时应用西地那非25mg，tid，连续服用30d，对照组给予常规治疗，如利尿剂、ACEI类、洋地黄类。用药前后化验NT—proBNP，应用美国通用公司的Vingrnedvivid7多功能彩色多普勒诊断仪测量左心室射血分数（LVEF）、肺动脉压。结果治疗组治疗前后LEVF提高（11．110±5．676）％，明显高于对照组[提高（2．700±1．977）％]，差异有统计学意义（t=3．981，P0〈0．01），NT—proBNP下降（1844．730±858．340）pg／ml，显著高于对照组[下降（894．470±890．371）pg／ml]，差异有统计学意义（t=3．064，P〈0．01），肺动脉压下降（8．400±3．869）mmHg，高于对照组[下降（3．600±3．291）mmHg]，差异有统计学意义（t=3．660，P〈0．0I）。结论与常规治疗组相比，左西孟旦联合西地那非治疗老年慢性心力衰竭伴肺动脉压升高患者有效，能显著降低肺动脉压，降低NT—proBNP，改善心功能。Objective To observe the efficacy of oral sildenafil combined with intravenous levo-simendan on patients with chronic heart failure and pulmonary hypertension. Methods From June 2012 to October 2012,18 patients with chronic congestive heart failure and pulmonary hypertension were ran-domised into control group and treatment group, with 15 cases in each group. In treatment group, on the basis of conventional treatment, patients were given an initial dose of levosimendan of 12 μg/kg, infused over 10 min,followed by a continuous infusion of 0. 1 p,g/（ kg · min） for 24 h, and oral seldenafil of 75 mg/d for 30 days. The patients in control group were given conventional treatment. NT-proBNP were tested before and after drug therapy, and LVEF and pulmonary artery pressure were measured by Vingmed vivid 7 Multifunctional color Doppler diagnostic instrument. Results In treatment group, LVEF in-creased higher than that in control group [ （ 11.110 ± 5. 676） % vs （2. 700 ± 1. 977 ） % ], there was sig-nificant difference （t = 3.981 ,P 〈 0. 01 ）; NT-proBNP decreased more in treatment group than that in control group [ （ 1844. 730 ± 858. 340 ） pg/ml vs （894. 470 ,± 890. 371 ） pg/ml ], there was significant difference（ t = 3.064, P 〈 0. 01 ） ; pulmonary artery pressure in treatment group decreased more than that in control group [ （8.400 ± 11. 344）mm Hg vs （3. 600 ± 3.291 ）mm Hg ], there was significant difference （ t = 3.660, P 〈 0. 01 ）. Conclusions Compared with conventional treatment, leosimendan combined with sildenafil could significantly reduce the pulmonary artery pressure and the NT-proBNP in patients with chronic heart failure and pulmonary hypertension, improve cardiac function, so it is effective.

关 键 词：左西孟旦 西地那非 慢性心力衰竭 肺动脉压升高 

分 类 号：R541.6[医药卫生—心血管疾病]