左西孟旦治疗难治性心力衰竭的临床效果分析  

Analysis of the clinical effect of levosimendan in the treatment of refractory heart failure

作　　者：张雪阳 腾飞[2] 安乐 赵丽新[2] 郭树彬[2] 梅雪[2] ZHANG Xueyang;TENG Fei;AN Le(Department of Emergency,Beijing Luhe Hospital of Capital Medical University,Beijing 101100,China)

机构地区：[1]首都医科大学附属北京潞河医院急诊科,101100 [2]首都医科大学附属北京朝阳医院急诊科,100020

出　　处：《中国现代药物应用》2022年第17期11-15,共5页Chinese Journal of Modern Drug Application

基　　金：2021年度“扬帆”计划重点医学专业老年急诊医学(项目编号:ZYLX202132)。

摘　　要：目的探讨左西孟旦治疗难治性心力衰竭的临床效果。方法83例难治性左心力衰竭患者,根据治疗方案不同分为左西孟旦组(53例)和常规治疗组(30例)。常规治疗组给予常规治疗,左西孟旦组在常规治疗组基础上加用左西孟旦治疗。比较左西孟旦组患者治疗前后相关指标[脑钠肽(BNP)、左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]及不同年龄段患者治疗后7 d相关指标[心肌肌钙蛋白I(cTnI)、BNP及△LVEF]、不同BNP水平患者治疗后7 d相关指标(cTnI、△BNP%及LVEF);比较两组患者相关指标(△BNP、△LVEF),两组心肌梗死后心力衰竭患者的相关指标(△BNP、LVEF)。结果治疗前至治疗后7 d,左西孟旦组的BNP水平呈下降趋势,且不同时间点两两比较差异均有统计学意义(P<0.05)。左西孟旦组治疗后7 d的LVEF高于治疗前、LVESD小于治疗前,差异具有统计学意义(P<0.05)。左西孟旦组治疗前和治疗后7 d的LVEDD比较差异无统计学意义(P>0.05)。左西孟旦组中<70岁患者18例,70~80岁患者17例,>80岁患者18例。治疗后7 d,左西孟旦组不同年龄段患者的cTnI、BNP及△LVEF水平比较差异均无统计学意义(P>0.05)。左西孟旦组根据治疗前BNP水平分为<1000 ng/L患者18例、1000~2000 ng/L患者14例及>2000 ng/L患者21例。治疗后7 d,左西孟旦组不同BNP水平患者的cTnI、△BNP%及LVEF比较差异均无统计学意义(P>0.05)。治疗后2、4、7 d,左西孟旦组的△BNP分别为395.00(34.50,1016.50)、496.00(153.00,1628.50)、565.00(170.00,1509.00)ng/L,均高于常规治疗组的82.00(-168.75,739.75)、200.00(-137.00,623.50)、205.50(17.25,785.75)ng/L,差异具有统计学意义(P<0.05);左西孟旦组患者的△LVEF%8.00(4.00,14.25)%明显高于常规治疗组的4.00(-1.25,10.50)%,差异具有统计学意义(P<0.05)。左西孟旦组中心肌梗死后心力衰竭患者30例,常规治疗组中心肌梗死后心力衰竭患者7例。左西�Objective To discuss the clinical effect of levosimendan in the treatment of refractory heart failure.Methods A total of 83 patients with refractory left heart failure were divided into levosimendan group(53 cases)and conventional treatment group(30 cases)according to different treatment regimens.The conventional treatment group was treated with conventional treatment,and the levosimendan group was additionally treated with levosimendan on the basis of the conventional treatment group.Comparison was made on related indicators[brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)]before and after treatment,related indicators[cardiac troponin I(cTnI),BNP and△LVEF]of patients in different age groups at 7 d after treatment,and related indicators(cTnI,△BNP%and LVEF)of patients with different BNP levels in levosimendan group at 7 d after treatment,related indicators(△BNP,△LVEF)between the two groups,and the related indicators(△BNP,LVEF)of the patients with heart failure after myocardial infarction in the two groups.Results The BNP levels in the levosimendan group showed a decreasing trend from before to 7 d after treatment,and the differences were statistically significant between the two comparisons at different time points(P<0.05).The LVEF in the levosimendan group at 7 d after treatment was higher than that before treatment and the LVESD was smaller than that before treatment,and the differences were statistically significant(P<0.05).There was no statistically significant difference in LVEDD before and 7 d after treatment in the levosimendan group(P>0.05).In the levosimendan group,18 patients were<70 years old,17 patients were 70-80 years old,and 18 patients were>80 years old.After 7 d of treatment,there was no statistically significant difference in the levels of cTnI,BNP and△LVEF in different age groups of the levosimendan group(P>0.05).In the levosimendan group,there were 18 patients with BNP

关 键 词：左西孟旦 难治性心力衰竭 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]