左西孟旦联合米力农治疗重症顽固性心衰的疗效及其对血清脑钠肽、尿酸的影响评价  

Efficacy of Levosimendan Combined with Milrinone in the Treatment of Severe Refractory Heart Failure and Its Effect on Serum Brain Natriuretic Peptide and Uric Acid

作　　者：温凤鹏 WEN Feng-peng(Department of Critical Care Medicine,People's Hospital of Juancheng County,Heze,Shandong Province,274600 China)

机构地区：[1]山东省鄄城县人民医院重症医学科

出　　处：《中外医疗》2019年第25期14-16,32,共4页China & Foreign Medical Treatment

摘　　要：目的研究探讨左西孟旦联合米力农治疗重症顽固性心力衰竭患者的效果,以及对患者的血清脑钠肽和尿酸的影响。方法方便选取该院重症顽固性心衰患者100例,选取时间为2016年7月-2017年8月,采用随机数字法分成对照组和观察组,各50例患者,对照组采取米力农治疗,观察组采取左西孟旦联合米力农治疗,观察并比较两组患者的血液及其代谢指标、心功能指标。结果观察组的脑钠肽水平为(248.39±25.18)μg/L,尿酸为(282.64±28.94)μmol/L,和对照组相比显著更低(t=28.22、11.01,P=0.01)。观察组的24 h尿量为(3 695.48±370.14)mL,显著高于对照组(t=7.08,P=0.01)。观察组的左心室收缩末期内径和左心室舒张末期内径分别为(36.75±3.27)mm、(47.82±4.52)mm,显著低于对照组(t=6.25、3.95,P=0.01)。观察组的左室射血分数为(47.85±4.36)%,显著高于对照组(t=6.73,P=0.01)。结论左西孟旦联合米力农治疗重症顽固性心衰,有效改善患者的心功能,疗效较为理想,有效降低患者的血清脑钠肽水平和尿酸水平。Objective To investigate the effect of levosimendan combined with milrinone in the treatment of patients with severe refractory heart failure and the effects of serum brain natriuretic peptide and uric acid on patients. Methods Convenient select 100 patients with severe refractory heart failure were enrolled in our hospital. The time was from July 2016 to August 2017. The patients were randomly divided into the control group and the observation group. 50 patients were treated with milrinone. The observation group was treated with levosimendan combined with milrinone. The blood and its metabolic indicators and cardiac function indexes were observed and compared between the two groups. Results The brain natriuretic peptide level of the observation group was (248.39±25.18)μg/L, and the uric acid was (282.64±28.94)μmol/L, which was significantly lower than that of the control group.(t=28.22,11.01, P=0.01). The 24-hour urine volume of the observation group was (3 695.48±370.14)mL, which was significantly higher than that of the control group(t=7.08,P=0.01). The left ventricular end-systolic diameter and left ventricular end-diastolic diameter of the observation group were (36.75±3.27) mm and (47.82±4.52) mm, respectively, which were significantly lower than the control group(t=6.25,3.95, P=0.01). The left ventricular ejection fraction of the observation group was (47.85±4.36)%, which was significantly higher than that of the control group(t=6.73,P=0.01). Conclusion Levosimendan combined with milrinone in the treatment of severe refractory heart failure, effectively improve the heart function of patients, the effect is ideal, and effectively reduce the serum brain natriuretic peptide level and uric acid level.

关 键 词：重症顽固性心衰 左西孟旦 米力农 血清脑钠肽 尿酸 

分 类 号：R5[医药卫生—内科学]