左西孟旦治疗难治性心力衰竭的效果及对患者炎症因子、血清NT-proBNP水平的影响  

Effect of levosimendan on refractory heart failure and its influences on levels of inflammatory factors and serum NT-proBNP of patients

作　　者：叶武成 高莉[2] YE Wucheng;GAO Li(Xingyuan Hospital of Yulin,Yulin 719000;Xi'an Electric Power Central Hospital,Xi'an 710043,China)

机构地区：[1]榆林市星元医院,陕西榆林719000 [2]西安电力中心医院,陕西西安710043

出　　处：《临床医学研究与实践》2022年第19期62-66,共5页Clinical Research and Practice

摘　　要：目的探讨左西孟旦治疗难治性心力衰竭的效果及对患者炎症因子、血清N末端B型脑钠肽前体(NT-proBNP)水平的影响。方法选取2018年1月至2021年1月榆林市星元医院收治的94例难治性心力衰竭患者为研究对象,采用随机数字表法将其分为对照组和观察组,各47例。对照组采取常规药物(酒石酸美托洛尔缓释片+阿托伐他汀钙片)治疗,观察组在对照组基础上增加左西孟旦。比较两组的临床疗效、心功能指标、炎症因子、NT-proBNP、心肌酶谱指标水平及不良反应发生情况。结果观察组的治疗总有效率为91.49%,高于对照组的74.47%,差异具有统计学意义(P<0.05)。治疗前,两组患者的左室射血分数(LVEF)、每搏输出量(SV)及左心室舒张末期内径(LVEDD)比较,差异无统计学意义(P>0.05);治疗后,观察组的LVEF、SV高于对照组,LVEDD小于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、NT-proBNP水平比较,差异无统计学意义(P>0.05);治疗后,两组的CRP、TNF-α、NT-proBNP水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组患者的心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶MB(CK-MB)及核因子-κB(NF-κB)水平比较,差异无统计学意义(P>0.05);治疗后,两组的cTnT、CK-MB及NF-κB水平均较治疗前降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论左西孟旦治疗难治性心力衰竭的效果显著,可减轻炎症反应及心肌损伤,改善患者的心功能,且安全性较高,值得在临床实践中推广应用。Objective To investigate the effect of levosimendan on refractory heart failure and its influences on levels of inflammatory factors and serum N-terminal pro-B-type natriuretic peptide(NT-proBNP) of patients. Methods Ninety-four patients with refractory heart failure admitted in Xingyuan Hospital of Yulin from January 2018 to January 2021 were selected as the research objects. The patients were divided into control group and observation group by random number table method, with 47 cases in each group. The control group was treated with conventional drugs(metoprolol tartrate sustained-release tablets + atorvastatin calcium tablets), and the observation group was added levosimendan on the basis of the control group. The clinical efficacy, levels of cardiac function indexes, inflammatory factors, NT-proBNP, myocardial zymogram indexes and adverse reactions were compared between the two groups. Results The total effective rate of treatment in the observation group was 91.49%, which was higher than 74.47% in the control group, and the difference was statistically significant(P<0.05). Before treatment, there were no significant differences in left ventricular ejection fraction(LVEF), stroke volume(SV) and left ventricular end diastolic diameter(LVEDD) between the two groups(P>0.05);after treatment, the LVEF and SV in the observation group were higher than those in the control group, the LVEDD was smaller than that in the control group, and the differences were statistically significant(P<0.05). Before treatment, there were no significant differences in the levels of C-reactive protein(CRP), tumor necrosis factor-α(TNF-α) and NT-proBNP between the two groups(P>0.05);after treatment, the levels of CRP, TNF-α and NT-proBNP in the two groups were lower than those before treatment, those in the observation group were lower than the control group, and the differences were statistically significant(P <0.05). Before treatment, there were no significant differences in the levels of cardiac troponin T(cTnT),creatine kinase is

关 键 词：难治性心力衰竭 左西孟旦 心功能 心肌酶谱 炎症因子 N末端B型脑钠肽前体 

分 类 号：R541.6[医药卫生—心血管疾病]