左西孟旦对经皮冠脉介入治疗术后高龄急性心肌梗死合并心力衰竭患者的疗效  

Effect of levosimendan on elderly patients with acute myocardial infarction and heart failure after percutaneous coronary intervention

作　　者：欧新琛 张献波[2] 黄昌志 OU Xinchen;ZHANG Xianbo;HUANG Changzhi(Department of Emergency,Wanning People's Hospital,Wanning 571500,China;Department of Cardiology,Wanning People's Hospital,Wanning 571500,China)

机构地区：[1]万宁市人民医院急诊科,万宁571500 [2]万宁市人民医院心内科,万宁571500

出　　处：《西北药学杂志》2022年第3期157-160,共4页Northwest Pharmaceutical Journal

基　　金：海南省卫生计生行业科研项目(编号:16A200012)。

摘　　要：目的研究左西孟旦对经皮冠脉介入治疗(PCI)术后高龄急性心肌梗死(AMI)合并心力衰竭病人的疗效及血清重组人半乳糖凝集素3(Gal-3)、正五聚蛋白3(PTX-3)表达的影响。方法将116例AMI合并心力衰竭病人作为研究对象,随机分为2组,各58例,所有病人均进行PCI手术治疗,观察组病人在术后联合采用左西孟旦治疗,比较2组病人的生命体征、心功能、药物有效性、Gal-3和PTX-3水平。结果治疗后,2组病人的心率、收缩压、舒张压以及呼吸频率均显著下降,且观察组病人的收缩压、心率、舒张压和呼吸频率较对照组明显下降(P<0.05);2组病人的左心房前后直径(LAD)、左心室射血分数(LVEF)显著升高,右心室内径(RVD)、左心室内径(LVD)、左心室舒张末期容积(LVEDV)下降(P<0.05),且观察组病人的LVEF.LAD较对照组明显增加,LVD、RVD和LVEDV较对照组明显减小(P<0.05);观察组病人的呼吸困难评分高于对照组,N末端B型利钠肽原显著低于对照组,观察组病人的正性肌力药物使用、循环辅助器械成功撤除、有创通气成功撤除情况显著低于对照组;2组病人的PTX-3和Gal-3水平均明显下降,且观察组病人较对照组下降更明显。结论PCI术后高龄AMI合并心力衰竭病人采用左西孟旦进行治疗,病人的血清Gal-3、PTX-3水平呈显著下降趋势,治疗效果显著。Objective To study the effect of levosimendan on the expression of galectin-3(Gal-3)and pentraxin-3(PTX-3)in elderly patients with acute myocardial infarction(AMI)and heart failure after percutaneous coronary intervention(PCI).Methods In this prospective study,116 patients with myocardial infarction and heart failure treated were selected as the research objects.According to the principle of random grouping,the above patients were randomly divided into 2 groups,58 cases in each group.All patients were treated with PCI.The observation group were treated with levosimendan after opera tion,and the curative effect of the 2.groups were compared in terms of vital signs,cardiac function,drug efficacy,Gal-3 and PTX-3 levels.Results After treatment,the heart rate,systolic blood pressure,diastolic blood pressure and respiratory rate of the 2 groups decreased significantly,and the heart rate,systolic blood pressure,diastolic blood pressure and respiratory rate of the observation group were obviously lower than the control group(P<0.05).The left atrial anteroposterior diameter(LAD),left ventricular ejection fraction(LVEF)of the 2 groups were signi ficantly increased,while the right ventricular diameter(RVD),left ventricular diameter(LVD),left ventricular end diastolic volume(LVEDV)were decreased(P<0.05).The LVEF and LAD of the observation group were significantly higher than control group,the LVD,RVD and LVEDV of the PCI group were significantly lower than of the control group(P<0.05).The dyspnea score of the observation group was higher than control group,and the N-terminal B-type natriuretic peptide was significantly lower than control group.The use of positive inotropic drugs,the successful removal of circulatory aid instrument system and invasive ventilation in observation group were significantly lower than in control group.The levels of Gal-3 and PTX-3 in the 2 groups decreased obviously,and the levels of Gal-3 and PTX-3 in observation group were significantly lower than in control group.Conclusion After PCI,the serum

关 键 词：左西孟旦 心肌梗死 经皮冠脉介入治疗(PCI) 重组人半乳糖凝集素3(Gal-3) 正五聚蛋白3(PTX-3) 

分 类 号：R972[医药卫生—药品]