左西孟旦在脓毒症诱导急性心力衰竭患者中的应用研究  

Effects of levosimendan on patients with sepsis-induced acute heart failure

作　　者：兰蕴平[1] 于佳 刘蓉安[1] 雷雨[1] 罗小秀 曾帆[1] LAN Yun-ping;YU Jia;LIU Rong-an;LEI Yu;LUO Xiao-xiu;ZENG Fan(Department of SICU,Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital,Chengdu 610072,China;Department of ICU,Chengdu Fifth People's Hospital,Chengdu 611130,China)

机构地区：[1]四川省人民医院重症医学中心,成都610072 [2]成都市第五人民医院重症医学科,成都611130

出　　处：《实用药物与临床》2018年第12期1369-1372,共4页Practical Pharmacy and Clinical Remedies

基　　金：四川省医学会医学科研课题计划项目(S16072)

摘　　要：目的探讨左西孟旦在脓毒症诱导急性心力衰竭患者中的疗效。方法收集2015年5月至2018年5月我科收治的45例脓毒症诱导急性心力衰竭患者。依照随机数字表法分为试验组(左西孟旦组,22例)、对照组(多巴酚丁胺组,23例),比较两组患者临床指标。结果两组患者年龄、性别比、APACHEⅡ评分、SOFA评分、感染部位比较,差异无统计学意义(P> 0. 05)。入组后7 d,两组APACHEⅡ评分、SOFA评分、NTPro BNP、cTnI、Lac均降低(P <0. 05),且试验组低于对照组(14. 55±3. 41、18. 39±6. 19,11. 82±2. 72、15. 04±4. 81,(2 575. 36±1 047. 74)、(3 344. 61±1 377. 21) ng/L,(1. 62±0. 87)、(2. 18±0. 94)μg/L,(2. 78±0. 99)、(3. 77±2. 05) mmol/L);两组CI、SVI、LVEF、Scv O2均升高(P <0. 05),且试验组高于对照组[(3. 39±0. 40)、(2. 99±0. 43) L/(min·m^2),(40. 27±3. 60)、(36. 22±3. 83) ml/m^2,50. 05%±5. 26%、45. 57%±5. 16%,65. 36%±5. 07%、62. 48%±4. 38%];试验组ICU住院时间较对照组缩短[(11. 57±3. 06)、(14. 10±3. 71) d]。两组上述指标比较差异均有统计学意义(P <0. 05或P <0. 01)。两组ICU住院费用、28 d死亡率比较差异无统计学意义(P> 0. 05)。结论脓毒症诱导急性心力衰竭患者应用左西孟旦可以降低疾病危重度评分,改善心功能及微循环灌注,缩短住院时间。Objective To explore the effects of levosimendan on patients with sepsis-induced acute heart failure.Methods Totally45patients with sepsis-induced acute heart failure were divided into iwo groups according to the random number lable method:experiment group(levosimendan group,n=22)and control group(dobutamine group,n=23).The clinical indexes between the two groups were compared.Results No significant difference was found in age,sex ratio,APACHE II,SOFA or the infection sites between the two groups(P>0.05).After7d.the scores of A-PACHE II and SOFA and the levels of NT-ProBNP,cTnI and Lac in both groups were decreased(P<0.05),and those in experimeni group were lower(14.55±3.41and18.39±6.19,11.82±2.72and15.04±4.81,(2575.36±1047.74)and(3344.61±1377.21)ng/L,(1.62±0.87)and(2.18±0.94)pg/L,(2.78±0.99>and(3.77±2.05)mmol/L;the CI,SVI,LVEF and ScvO2in boili groups were increased(P<0.05),and those in experiment group were higher[(3.39±0.40〉and(2.99±0.43〉L/(min·m^2〉,(40.27±3.60)and(36.22±3.83〉ml/m^2,50.05%±5.26%and45.57%±5.16%,65.36%±5.07%and62.48%±4.38%];the length of ICU stay in experiment group was shorter than that in control group[(11.57±3.06)and(14.10±3.71)d].There were significant differences in the above indexes between the two groups(P<0.05).No significant difference was found in ICU expense or28-day mortality between the groups(P>0.05).Cronclusion Levosimendan can improve the severity of illness and cardiac function as well as the microcirculation perfusion,and shorten the length of ICU stay in patients with sepsis-induced acute heart failure.

关 键 词：脓毒症 心肌抑制 心力衰竭 左西孟旦 

分 类 号：R541.6[医药卫生—心血管疾病]