左西孟旦辅助常规西药治疗重症肺动脉高压并右心衰竭患者的疗效及安全性分析  

Efficacy and safety analysis of levosimendan adjunctive to conventional Western medicine in the treatment of patients with severe pulmonary hypertension and right heart failure

作　　者：林叶涛 刘超远 LIN Ye-tao;LIU Chao-yuan(Department of Cardiology,the Second Affiliated Hospital of Shantou University Medical College,Shantou 515000,China)

机构地区：[1]汕头大学医学院第二附属医院心血管内科,515000 [2]汕头大学精神卫生中心精神科,515000

出　　处：《中国实用医药》2024年第6期96-99,共4页China Practical Medicine

摘　　要：目的 探讨左西孟旦辅助常规西药治疗重症肺动脉高压并右心衰竭患者的疗效及安全性。方法 选取70例重症肺动脉高压并右心衰竭患者,采取随机数字表法分为对照组和观察组,每组35例。对照组采用常规西药治疗,观察组在对照组基础上给予左西孟旦辅助治疗。比较两组患者治疗效果、心功能指标、脑钠肽水平以及不良反应发生率。结果 对照组治疗总有效率为77.14%,观察组治疗总有效率为97.14%,观察组明显高于对照组(χ^(2)=6.248, P=0.012<0.05);治疗前,两组患者左室射血分数(LVEF)、右室射血分数(RVEF)、B型利钠肽(BNP)水平比较,差异无统计学意义(P>0.05);治疗后,两组患者LVEF、RVEF均升高, BNP均降低,且观察组LVEF(56.56±6.35)%、RVEF(52.34±5.42)%明显高于对照组的(44.32±6.25)%、(42.36±5.26)%, BNP(542.61±123.65)pg/ml明显低于对照组(853.62±185.33)pg/ml(P<0.05);对照组不良反应发生率为17.14%,观察组不良反应发生率为20.00%,两组患者不良反应发生率比较,差异无统计学意义(χ^(2)=0.095, P=0.759>0.05)。结论 在重症肺动脉高压并右心衰竭患者的治疗中,应用左西孟旦能够提高患者治疗效果,改善心肌缺血情况,且用药安全,具有临床应用价值。Objective To explore the efficacy and safety of levosimendan adjunctive to conventional Western medicine in the treatment of patients with severe pulmonary hypertension and right heart failure.Methods 70 patients with severe pulmonary hypertension and right heart failure were divided into a control group and an observation group by random number table method,with 35 cases in each group.The control group was treated with conventional Western medicine,and the observation group was treated with levosimendan based on the control group.The therapeutic effect,cardiac function indicators,brain natriuretic peptide level and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the control group was 77.14%,while the total effective rate of the observation group was 97.14%.The observation group was significantly higher than the control group(χ^(2)=6.248,P=0.012<0.05).Before treatment,there was no significant difference in left ventricular ejection fraction(LVEF),right ventricular ejection fraction(RVEF)and B-type natriuretic peptide(BNP)levels between the two groups(P>0.05).After treatment,LVEF and RVEF increased and BNP decreased in both groups;the observation group had LVEF of(56.56±6.35)%and RVEF of(52.34±5.42)%,which were significantly higher than(44.32±6.25)%and(42.36±5.26)%in the control group;the observation group had significantly lower BNP of(542.61±123.65)pg/ml than(853.62±185.33)pg/ml in the control group(P<0.05).The incidence of adverse reactions in the control group was 17.14%,while that in the observation group was 20.00%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.095,P=0.759>0.05).Conclusion In the treatment of patients with severe pulmonary hypertension and right heart failure,the application of levosimendan can improve the therapeutic effect of patients,improve myocardial ischemia,and the use of medication is safe,which has clinical application value.

关 键 词：左西孟旦 重症肺动脉高压 右心衰竭 安全性 

分 类 号：R544.1[医药卫生—心血管疾病] R541.6[医药卫生—内科学]