参麦注射液联合左西孟旦治疗老年急性心力衰竭的疗效分析  

Clinical effect of Shen-mai injection combined with levosimendan on acute heart failure in elderly patients

作　　者：徐俊松 孟冉 蒋峻[2] 吴玉泉[1] 许娟[1] XU Junsong;MENG Ran;JIANG Jun(Geriatric Medicine Department, the 117th Hospital of PLA, Hangzhou 310007,China)

机构地区：[1]中国人民解放军第一一七医院老年医学科,310013 [2]浙江大学医学院附属第二医院心内科

出　　处：《心电与循环》2018年第3期177-180,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨参麦注射液联合左西孟旦治疗老年急性心力衰竭的临床疗效和安全性。方法选择老年急性心力衰竭患者156例,采用随机数字表法分为3组。对照组给予常规抗心力衰竭治疗(利尿剂、ACEI或ARB、β受体阻滞剂),左西孟旦组在对照组治疗基础上加用左西孟旦,联合治疗组在左西孟旦组治疗基础上加用参麦注射液。记录3组患者治疗前后左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)、每搏输出量(SV)、氨基末端脑钠肽前体(NT-proBNP)以及不良反应。结果与治疗前比较,3组患者治疗2周后LVEDD、LVEF、SV、NT-proBNP均明显改善(均P<0.05)。与对照组比较,左西孟旦组、联合治疗组治疗24h、2周时LVEDD、LVEF、SV、NT-proBNP均明显改善,差异均有统计学意义(均P<0.05)。治疗2周时,联合治疗组LVEDD、LVEF、SV、NT-proBNP与左西孟旦组比较明显改善,差异均有统计学意义(均P<0.05)。低血压发生率下降差异有统计学意义(P<0.05)。结论参麦注射液联用左西孟旦治疗老年急性心力衰竭能更有效控制患者心力衰竭的症状,改善患者的心功能,且安全性良好。Objective To investigate the clinical efficacy and safety of Shen-mai injection combined with levosimendan in the treatment of elderly patients with acute heart failure（AHF）. Methods 156 cases of elderly patients with AHF were randomly divided into 3 groups. All patients received conventional therapy for heart failure（ACEI or ARB,diuretics, beta blockers）. Group B was treated with levosimendan and Group C treated with Shen-mai injection and levosimendan in addition to conventional therapy. Left ventricular end diastolic diameter（LVEDD）, left ventricular ejection fraction（LVEF）, stroke volume（SV） and N terminal B type natriuretic peptide（NT-proBNP） were measured before and after treatment. The adverse reactions were also evaluated. Results LVEDD, LVEF, SV and NT-proBNP improved significantly after 2 weeks of treatment in each group（all P〈0.05）. LVEDD, LVEF, SV and NT-proBNP improved significantly more in group B and C（P〈0.05） than in group A at 24 h and 2 weeks after treatment, and significantly more in group C than in group B at 2 weeks after treatment（P〈0.05）. The incidence of hypotension was significantly lower in group C（P〈0.05）. Conclusion Shen-mai injection combined with levosimendan are effective and safety in treatment of acute heart failure in elderly patients.

关 键 词：急性心力衰竭 左西孟旦 参麦注射液 老年 

分 类 号：R541.6[医药卫生—心血管疾病]