左西孟旦联合硝酸甘油治疗急性失代偿性心力衰竭的临床分析  

Clinical Analysis on the Treatment of Acute Decompensated Heart Failure through Levosimendan Combined with Nitroglycerin

作　　者：冯庆芝[1] 

机构地区：[1]山东省菏泽市立医院,山东菏泽274031

出　　处：《中国医学创新》2016年第18期37-40,共4页Medical Innovation of China

摘　　要：目的:探讨左西孟旦联合硝酸甘油治疗急性失代偿性心力衰竭的临床效果。方法:选取2014年8月-2015年8月本院急诊科收治的116例急性失代偿性心力衰竭患者作为研究对象,按照随机数字表法分为对照组和观察组,每组58例。两组患者均根据个体化给予洋地黄制剂、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)、利尿剂、β受体阻断剂等。对照组加用硝酸甘油,观察组在对照组基础上加用左西孟旦,3 d后评价疗效。比较两组每搏输出量(SV)、心脏指数(CI)、左心室射血分数(LVEF)、治疗前后平均尿量、血清氨基末端脑钠肽(NT-pro BNP)及胱抑素C(Cys C)。结果:治疗前两组SV、CI及LVEF比较差异均无统计学意义(P>0.05),治疗后两组SV、CI及LVEF均较治疗前明显升高,观察组SV和LVEF较对照组升高更明显,比较差异均有统计学意义(P<0.05);两组治疗后平均尿量均较治疗前增加,且观察组增加更明显,比较差异均有统计学意义(P<0.05);两组治疗后NT-pro BNP和Cys C均较治疗前降低,且观察组低于对照组,比较差异均有统计学意义(P<0.05)。结论:左西孟旦联合硝酸甘油治疗急性失代偿性心力衰竭临床效果更明显。Objective： To study the clinical effect in the treatment of acute decompensated heart failure through Levosimendan combined with Nitroglycerin.Method： From August 2014 to August 2015, 116 cases of acute decompensated heart failure in our hospital emergency department were selected as the research objects, they were divided into the control group and the observation group according to the random number table method, each group had 58 cases.According to the individual two groups were given Digitalis preparations, angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor blockers （ ACEI/ARB ）, diuretics, β blockers, etc.The control group added with Nitroglycerin and the observation group added with Levosimendan on basis of the control group, the curative effect was evaluated after 3 days.Two groups of stroke volume （ SV ）, cardiac index （ CI ）, left ventricular ejection fraction （ LVEF ）, mean urine volume before and after treatment, serum N-terminal pro brain natriuretic peptide （ NT-proBNP ） and cystatin C （ CysC ） were compared.Result： There were no significant differences in LVEF, CI and SV in two groups before treatment （ P〉0.05 ） .SV, CI and LVEF were significantly increased in two groups after treatment than before treatment, SV and LVEF in the observation group were significantly higher than those of the control group, the differences we/＇e statistically significant （ P〈0.05 ） .The average urine volume of two groups were increased after treatment than before treatment and the observation group increased more significantly than control group, the differences were statistically significant （P〈0.05） .After treatment, CysC and NT-proBNP in two groups were lower than before treatment and the observation group was lower than the control group, the differences were statistically significant （P〈0.05） .Conclusion： The clinical effect in the treatment of acute decompensated heart failure with Levosimendan combined with Nitroglycerin is more obvious.

关 键 词：心力衰竭 硝酸甘油 左西孟旦 疗效 

分 类 号：R541.6[医药卫生—心血管疾病]