左西孟旦在急性心衰患者中的临床应用  

Clinical Application of Simendan on Acute Heart Failure

作　　者：翟莉[1,2] 李勤明 胡艳丽 肖洒[1,2] 单青 ZHAI Li LI Qin-ming HU Yan-li XIAO Sa SHAN Qing(Second Hospital of Beijing Municipal Corps, Chinese People ＇s Armed Police Forces, Beijing 10037, China.)

机构地区：[1]武警北京总队第二医院心血管内科,北京市100037 [2]政治工作部金沟河干休所,北京市100081

出　　处：《中国分子心脏病学杂志》2017年第4期2156-2158,共3页Molecular Cardiology of China

摘　　要：目的观察左西孟旦在急性心力衰竭患者中的临床疗效及安全性。方法入选30例急性失代偿性心力衰竭(ADHF)患者。全部患者在接受常规心力衰竭治疗的基础上应用左西孟旦,所有患者首先给予维持剂量0.05μg/kg/min静脉泵入,如患者能耐受,则2 h后增加剂量到0.1μg/kg/min持续静脉泵入,共给药12.5mg。治疗结束后,受试者接受为期5~7d的住院观察。在此期间进行心脏超声检测(统一的操作培训后采用Simpson法),检测呼吸困难改善及全身临床症状改善程度、心功能分级改善程度、血浆N末端B型利钠肽原NT-proBNP,并进行安全性评价。结果应用左西孟旦静脉泵入后,患者的临床改善情况良好,呼吸困难明显减轻,心脏功能明显好转,差异都有统计学意义(P<0.01)。同时患者用药后心脏的大小均较用药前缩小,射血分数(EF)明显增加,血浆N末端B型利钠肽原(NT-proBNP)明显下降,差异都有统计学意义(P<0.01)。3例患者出现一过性低血压,在增加多巴胺静脉泵入剂量后均未出现严重后果。结论左西孟旦可以改善ADHF患者呼吸困难的症状,显著降低患者N末端B型利钠肽原水平,提高患者的LVEF,并且耐受性和安全性较好。Objective To observe the clinical efficacy and safety of Simendan in patients with acute heart failure. Method A total of 30 patients with acute decompensated heart failure（ADHF） were enrolled. All patients were treated with Simendan on the basis of conventional heart failure treatment. And they were all firstly given a maintenance dose of 0.05 g/kg/min via venous pump. If the patients could tolerate,then 2 hours after the dose increased to 0.1 g/kg/min, continuous via venous pump, a total of 12.5mg. After the treatment, subjects underwent a 5~7 days hospital stay. During this period, echocardiography was performed（unified operation training and Simpson method was adopted）,moreover the detection of dyspnea improvement, overall improvement of clinical symptoms, improvement of cardiac function classification,N-terminal B-type natriuretic peptide（NT-proBNP） and safety evaluation were all performed. Results After the application of Simendan intravenous pump, the patient＇s clinical improvement was excellent, dyspnea was markedly alleviated, and heart function improved obviously.The differences were statistically significant（P〈0.01）. Meanwhile, the heart size of the patients was lower than that before the medication was taken, ejection fraction（EF） increased significantly, N-terminal B-type natriuretic peptide（NT-proBNP） decreased obviously. The differences were statistically significant（P〈0.01）. Transient hypopiesis occurred in 3 patients, no grave consequences were observed after increasing the dopamine intravenous infusion dose. Conclusion Simendan can improve the symptoms of dyspnea in patients with ADHF, significantly reduce the level of N-terminal B-type natriuretic peptide in patients, and improve the LVEF of patients, and has good tolerability and safety.

关 键 词：左西孟旦 急性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]