左西孟旦对顽固性心力衰竭患者心功能和N末端脑钠肽前体水平的影响  

Effects of levosimendan on cardiac function and N-terminal pro-brain natriuretic peptide in patients with refractory heart failure

作　　者：汪韶君[1] 王学忠[1] 张先林[1] 王岳松[1] 章萍[1] Wang Shaojun;Wang Xuezhong;Zhang Xianlin;Wang Yuesong;Zhang Ping(Department of Cardiology, Maanshan People's Hospital, Maanshan 243000, China)

机构地区：[1]马鞍山市人民医院心内科,马鞍山243000

出　　处：《中国循证心血管医学杂志》2017年第8期944-946,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的研究左西孟旦对顽固性心力衰竭患者心功能和N末端脑钠肽前体(NT-proBNP)水平的影响。方法选取2014年8月~2015年7月于马鞍山市人民医院心内科收治的72例顽固性心力衰竭患者,根据随机数字表法分为观察组和对照组,每组36例。对照组采取常规治疗,观察组在常规治疗基础上加左西孟旦注射液进行治疗。观察患者治疗前后心功能指标和NT-proBNP水平改善情况,比较两组患者的临床疗效和不良反应。结果治疗后,观察组的左室舒张末期内径(LVEDD)低于对照组[(62.43±2.31)mm vs.(66.45±3.21)mm],左室射血分数(LVEF)、心脏指数(CI)、每搏输出量(SV)高于对照组[(41.02±4.45)%vs.(37.24±4.24)%,(2.91±0.45)L/min·m2 vs.(2.48±0.38)L/min·m2,(49.21±5.32)ml vs.(44.32±4.45)ml],差异均有统计学意义(P<0.05)。观察组的NT-proBNP水平低于对照组[(3532.14±64.32)ng/L vs.(5321.55±93.53)ng/L](P<0.05)。观察组总的有效率高于对照组[91.67%(33/36)vs.66.67%(24/36)](P<0.05)。观察组和对照组的不良反应率比较差异无统计学意义[5.56%(2/36)vs.8.33%(3/36)](P>0.05)。结论左西孟旦可有效改善顽固性心力衰竭患者心功能和NT-proBNP水平,临床疗效较为显著,安全性高。Objective To investigate the effects of levosimendan on cardiac function and N-terminal probrain natriuretic peptide(NT-proBNP)in patients with refractory heart failure.Methods A total of72patients with refractory heart failure were chosen from August2014to July2014,and divided into observation group and control group.Control group were treated with conventional treatment,observation group were given levosimendan injection for treatment on the basis of control group.Before and after treatment,patients with cardiac function index and the NT-proBNP level improvement were measured.Clinical curative effect and adverse reaction were compared.Results After treatment,left ventricular end-diastolic diameter(LVEDD)of observation group was significantly lower than that of control group[(62.43±2.31)mm vs.(66.45±3.21)mm].Left ventricular ejection fraction(LVEF)and cardiac index(CI),stroke volume(SV)were significantly higher than the control group[(41.02±4.45)%vs.(37.24±4.24)%,(2.91±0.45)L·min-1·m-2vs.(2.48±0.38)L·min-1·m-2,(49.21±5.32)ml vs.(44.32±4.45)],the difference had statistical significance(P<0.05).NT-proBNP of observation group was significantly lower than that of control group(3532.14±64.32ng/L vs.(5321.55±93.53ng/L](P<0.05).Total effectiveness in observation group was significantly higher than that in control group[91.67%(33/36)vs.66.67%(24/36)](P<0.05).There was no significant difference between the observation group and the control group in the adverse reaction rate[5.56%(2/36)vs.8.33%(3/36)](χ2=0.2149,P>0.2149).Conclusion Levosimendan can effectively improve cardiac function in patients with refractory heart failure and N-terminal level of b-type natriuretic peptide precursor,clinical curative effect is significant,and high safety.

关 键 词：左西孟旦 心力衰竭 心功能 N末端脑钠肽前体 

分 类 号：R541.61[医药卫生—心血管疾病]