左西孟旦联合生脉注射液治疗急性心肌梗死泵衰竭55例  

Levosimendan combined with Shengmai injection for the treatment of pump failure in 55 patients with acute myocardial infarction

作　　者：栾桂霞 赵雪丽 郑鑫 Luan Guixia;Zhao Xueli;Zheng Xin(Department of Cardiology,Jiaozhou People's Hospital(South Branch),Jiaozhou 266300,Shandong Province,China;Department of Internal Medicine,Sanlihe Health Service Center,Jiaozhou 266300,Shandong Province,China;Department of Cardiology,Jiaozhou People's Hospital,Jiaozhou 266300,Shandong Province,China)

机构地区：[1]胶州市人民医院(南院)心血管内科,胶州266300 [2]胶州市三里河街道卫生服务中心内科,胶州266300 [3]胶州市人民医院心内科,胶州266300

出　　处：《中国基层医药》2022年第1期23-27,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的观察左西孟旦联合生脉注射液治疗急性心肌梗死泵衰竭的疗效及其对患者组织灌注、氧代谢的影响。方法选取胶州市人民医院2019年7月至2020年12月收治的急性心肌梗死泵衰竭患者110例,采用随机数字表法分为对照组、观察组各55例。对照组采用包括心电监护及氧饱和度监护、氧气疗法,双联抗血小板药物、他汀类药物、血管活性药物、硝酸酯类等常规治疗,观察组在常规治疗基础上采用左西孟旦联合生脉注射液治疗,两组疗程10 d。观察两组临床疗效、治疗前后心功能及组织灌注、氧代谢指标,随访1个月,比较两组病死率。结果观察组总有效率为58.18%(32/55),高于对照组的38.18%(21/55),差异有统计学意义(χ^(2)=4.41,P<0.05)。治疗后,观察组左室舒张末期内径、左室射血分数、每搏量均优于对照组,均差异有统计学意义(t=-2.29、-5.85、-7.33,均P<0.05);观察组氧分压、氧合指数、中心静脉血氧饱和度、乳酸、乳酸清除率、尿量分别为(103.53±9.85)mmHg、(247.69±18.95)mmHg、(77.56±3.59)%、(3.02±0.45)mmol/L、(42.89±5.22)%、(40.88±1.64)mL/h,对照组分别为(95.47±11.98)mmHg、(194.69±16.52)mmHg、(70.88±2.13)%、(3.58±0.51)mmol/L、(36.89±5.14)%、(36.55±2.23)mL/h,两组均差异有统计学意义(t=-3.85、-15.64、-11.87、3.11、-6.07、-11.27,均P<0.001)。随访1个月,观察组病死率[3.64%(2/55)]低于对照组[16.36%(9/55)],差异有统计学意义(χ^(2)=4.95,P<0.05)。结论左西孟旦联合生脉注射液治疗急性心肌梗死泵衰竭可获得较为显著的临床疗效,可提高心功能,改善组织灌注及氧代谢水平,降低病死率。Objective To investigate the effects of levosimendan combined with Shengmai injection on pump failure in patients with acute myocardial infarction and its effects on tissue perfusion and oxygen metabolism.Methods A total of 110 patients with acute myocardial infarction and pump failure who received treatment in Jiaozhou People's Hospital(South Branch)from July 2019 to December 2020 were included in this study.They were randomly assigned to receive either routine treatments including electrocardiography monitoring,oxygen saturation monitoring,oxygen therapy,dual antiplatelet therapy,statins,vasoactive drugs,and nitrates(control group,n=55)or levosimendan combined with Shengmai injection based on routine treatments(observation group,n=55)for 10 successive days.Curative efficacy,cardiac function,tissue perfusion,and oxygen metabolism capacity were compared between the control and observation groups.The 1-month mortality rate was compared between the two groups.Results Total effective rate was significantly higher in the observation group than in the control group[58.18%(32/55)vs.38.18%(21/55),χ^(2)=4.41,P<0.05].After treatment,left ventricular end-diastolic diameter,left ventricular ejection fraction,and stroke volume were superior in the observation group to in the control group(t=2.12,–5.85,–7.33,all P<0.05).Oxygen partial pressure,oxygenation index,central venous oxygen saturation,lactate,lactate clearance rate,and urine volume in the observation group were(103.53±9.85)mmHg,(247.69±18.95)mmHg,(77.56±3.59)%,(3.02±0.45)mmol/L,(42.89±5.22)%,(40.88±1.64)mL/hour,respectively,and they were(95.47±11.98)mmHg,(194.69±16.52)mmHg,(70.88±2.13)%,(3.58±0.51)mmol/L,(36.89±5.14)%,and(36.55±2.23)mL/hour,respectively in the observation group.There were significant differences in these indices between the control and observation groups(t=–3.85,–15.64,–11.87,3.11,–6.07,–11.27,all P<0.001).At 1 month of follow-up,mortality rate was significantly lower in the observation group than in the control group[3.64%

关 键 词：心肌梗死 心力衰竭 药物疗法 联合 左西孟旦 生脉注射液 心肌再灌注 氧代谢 心脏功能试验 疗效比较研究 

分 类 号：R542.22[医药卫生—心血管疾病]