左西孟旦与米力农治疗重度慢性心力衰竭急性发作的疗效比较  

Efficacy of levosimendan vs milrinone in patients with acute attack of severe chronic heart failure

作　　者：陈志高[1] 张冲 

机构地区：[1]东南大学附属江阴医院,江苏江阴214400 [2]江阴市青阳医院,江苏江阴214400

出　　处：《中南药学》2015年第11期1224-1227,共4页Central South Pharmacy

摘　　要：目的评价在常规治疗效果不佳的基础上分别应用左西孟旦及米力农治疗重度慢性心力衰竭急性发作患者的有效性及安全性。方法共入选本院56例重度慢性心力衰竭急性发作患者,随机分为米力农组(29例)及左西孟旦组(27例),分别静脉滴注72、24 h,初始用药后72 h评价其脑尿钠肽(BNP)、左心射血分数(LVEF)、呼吸困难情况、心功能及血压、心率、肝肾功能等治疗前后的变化。结果治疗后,左西孟旦组BNP较米力农组下降更为显著[(891.6±621.3)pg·m L-1 vs(398.8±378.9)pg·m L-1,P<0.05],且LVEF提升明显[(6.38±3.56)%vs(3.09±1.86)%,P<0.05]。同时,左西孟旦组较米力农组呼吸困难症状及心功能改善更为明显(呼吸困难症状好转率66.6%vs 37.9%,P=0.032<0.05;心功能显效率59.3%vs 31.0%,P=0.034<0.05)。2组均未发生严重的不良事件。结论与米力农相比,左西孟旦对于治疗重度慢性心力衰竭急性发作患者可更好地降低BNP及改善呼吸困难症状,且安全性及耐受性良好。Objective To evaluate the efficacy and safety of levosimendan or milrinone in patients with acute attack of severe chronic heart failure besides conventional medications. Methods Fifty-six patients from our hospital were randomly divided into a milrinone group（n = 29） and a levosimendan group（n = 27）. Milrinone was administered for 72 h in the milrinone group, while levosimendan for 24 h in the levosimendan group. Changes in the B-type natriuretic peptide（BNP） plasma level, left ventricular ejection fraction（LVEF）, dyspnea, cardiac function, blood pressure, heart rate and hepatorenal function were compared before and after the treatment. Results The BNP plasma level in the levosimendan group after the treatment significantly increased than that in the milrinone group [（891.6±621.3） pg·mL^-1vs（398.8±378.9） pg·mL^-1 P〈0.05]. LVEF was also improved obviously [（6.38±3.56）% vs（3.09±1.86）%, P〈0.05]. Meanwhile, dyspnea and cardiac function improved greatly in the levosimendan group compared with that in the milrinone group（improvement rate 66.6% vs 37.9%, P = 0.032 〈0.05; 59.3% vs 31.0%, P = 0.034 〈0.05）. No significant adverse event was found in the 2 groups. Conclusion Levosimendan may bring better outcome of BNP and dyspnea than milrinone, and it is safe and well tolerated.

关 键 词：左西孟旦 心力衰竭 米力农 临床疗效 

分 类 号：R972[医药卫生—药品]