左西孟旦治疗老年慢性心力衰竭的临床疗效及安全性  

Clinical efficacy and safety of levosimendan in treatment of senile chronic heart failure

作　　者：李同社[1] 高振华[1] 杨智宏[1] 靳飞鹏 

机构地区：[1]河南科技大学第三附属医院/洛阳东方医院心血管内科,河南洛阳471003

出　　处：《现代医药卫生》2016年第16期2481-2483,共3页Journal of Modern Medicine & Health

摘　　要：目的评价左西孟旦治疗老年慢性心力衰竭的临床疗效及安全性。方法将2015年1月至2016年1月在该院心血管内科住院治疗的64例慢性心力衰竭患者按照随机数字表法分为基础治疗组和左西孟旦组,各32例。基础治疗组患者给予洋地黄、呋塞米、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)、螺内酯、β受体阻滞剂、曲美他嗪等常规抗心力衰竭综合治疗;左西孟旦组患者在基础治疗组基础上加用左西孟旦注射液,以0.1μg/(kg·min)的速度微量泵持续泵入24 h。观察两组患者治疗前与治疗7 d后的血压、心率、心功能、24 h尿量,钾、钠、氯离子的含量,肝肾功能,脑钠肽前体(pro-BNP),左室舒张末期内径(LVEDd),左室收缩末期内径(LVESd)、左室射血分数(LVEF)、心脏指数(CI)等指标的变化。结果与治疗前比较,两组患者治疗7 d后的LVEDd、LVESd变小,pro-BNP水平下降,LVEF及CI升高,差异均有统计学意义(P<0.05)。与基础治疗组比较,左西孟旦组患者治疗7 d后的血压、心率下降,心功能好转,24 h尿量显著增加,pro-BNP水平下降,LVEDd及LVESd变小,LVEF与CI升高,差异均有统计学意义(P<0.05);左西孟旦组总有效率[75.0%(24/32)]高于对照组[68.8%(22/32)],差异有统计学意义(P<0.05)。两组均无严重不良反应发生。结论左西孟旦注射液治疗老年慢性心力衰竭可改善治疗效果,安全性好。Objective To evaluate the clinical efficacy and safety of levosimendan in treating senile chronic heart failure.Methods Sixty-four cases of senile chronic heart failure hospitalized in the cardiology department of our hospital from January2015 to January 2016 were randomly divided into the levosimendan group and basic treatment group,32 cases in each group. The basic treatment group was given the regular anti-cardiac failure treatment of digitalis,furosemide,ACEI/ARB,spironolactone,β-blockers and trimetazidin;while the levosimendan group was given levosimendan injection by microinfusion pump with a speed of 0.1 μg/（kg·min） for consecutive 24 h based on the basis of basic treatment. Blood pressure,heart rate,heart function,24 h urine volume,potassium,natrium and chloride ions,hepatorenal function,pro-BNP,changes of LVEDd,LVESd,LVEF and CI before treatment and after 7 d treatment were observed in both groups. Results Compared with before treatment,LVEDd and LVESd after 7 d treatment in the two groups were decreased,the pro-BNP level was decreased,LVEF and CI were increased,the dif ferences were statistically significant（P〈0.05）. Compared with the basic treatment group,the blood pressure and heart rate after 7d treatment in the levosimendan group were decreased,the cardiac function was improved,24 h urine volume was increased,proBNP was declined,LVEDd and LVESd were decreased,while CI was increased,the differences were statistically significant（P〈0.05）;the total effective rate in the levosimendan group was 75.0%（24/32）,which was higher than 68.8%（22/32）,the difference was statistically significant（P〈0.05）. There were no serious adverse reactions in both groups. Conclusion Levosimendan injection for treating senile chronic heart failure can improve the treatment effect with good safety.

关 键 词：心力衰竭 老年人 利钠肽 脑 治疗结果 左西孟旦注射液 

分 类 号：R972[医药卫生—药品]