间断重复应用左西孟旦治疗终末期心力衰竭的疗效及安全性  

Efficacy and safety of intermittent application of levosimendan in patients with advanced heart failure

作　　者：张利方[1] 刘营[2] 刘莹[3] 王祯祯 郭孝兹 张雪娟[1] Zhang Lifang;Liu Ying;Liu Ying;Wang Zhenzhen;Guo Xiaoci;Zhang Xuejuan(Department of General Practice,The Affiliated Hospital of Qingdao University,Qingdao 266003,China.)

机构地区：[1]青岛大学附属医院全科医学科,青岛266003 [2]青岛大学附属医院感染科,青岛266003 [3]青岛大学附属医院重症医学科,青岛266003

出　　处：《中国循证心血管医学杂志》2021年第5期612-615,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨间断重复应用左西孟旦治疗终末期心力衰竭的疗效及安全性。方法回顾性分析2017年1月至2019年4月于青岛大学附属医院全科医学科住院治疗的78例终末期心力衰竭患者,根据治疗方案,分为左西孟旦组(43例)和对照组(35例)。所有患者均给予常规抗心衰治疗,左西孟旦组在出院后3个月内间断应用左西孟旦治疗。比较两组患者N末端脑钠肽前体(NT-proBNP)、NYHA心功能分级、左心室射血分数(LVEF)等临床指标的差异。结果与对照组相比,左西孟旦组NT-proBNP降幅更显著[(-2050±821)pg/ml vs.(-962±440)pg/ml,P=0.000];NYHA心功能分级、LVEF改善更明显[(-1.37±0.49)vs.(-0.97±0.29),P=0.000;(4.1±2.8)%vs.(2.3±1.9)%,P=0.001];两组生存曲线差异有统计学意义(HR=0.365,95%CI:0.187~0.712,P=0.002)。应用左西孟旦过程中未观察到严重不良反应。结论间断重复应用左西孟旦可改善终末期心力衰竭患者的心功能,降低再入院率,且安全性较好。Objective To explore the efficacy and safety of intermittent application of levosimendan in patients with advanced heart failure.Methods Seventy-eight patients with advanced heart failure who were hospitalized in the Affiliated Hospital of Qingdao University from January 2017 to April 2019 were selected and randomly divided into levosimendan group(n=43)and control group(n=35).All patients were given conventional anti-heart failure therapy,and the levosimendan group was intermittently treated with levosimendan within 3 months after discharge.The differences in clinical indicators such as N-terminal pro-brain natriuretic peptide(NTproBNP),NYHA cardiac function grading and left ventricular ejection fraction(LVEF)were compared between the 2 groups.Results Compared with the control group,NT-proBNP decreased more significantly in the levosimendan group[(-2050±821)pg/ml vs.(-962±440)pg/ml,P=0.000];NYHA cardiac function grading and LVEF improved more obvious[(-1.37±0.49)vs.(-0.97±0.29),P=0.000;(4.1±2.8)%vs.(2.3±1.9)%,P=0.001];the difference in survival curves between the two groups was statistically significant(HR=0.365,95%CI:0.187~0.712,P=0.002).No serious adverse events were observed during the application of levosimendan.Conclusion Intermittent application of levosimendan can improve the cardiac function of patients with advanced heart failure,reduce the rehospitalization rate,and it is safe.

关 键 词：左西孟旦 间断 终末期心力衰竭 

分 类 号：R541.61[医药卫生—心血管疾病]