左西孟旦在急性心肌梗死合并心力衰竭患者中的应用  

Application of Levosimendan in patients with acute myocardial infarction complicated with heart failure

作　　者：董宁超[1] 邢成伟 程国杰[1] DONG Ningchao;XING Chengwei;CHENG Guojie(Department of Cardiology,Daxing District People’s Hospital,Beijing102600,China)

机构地区：[1]北京市大兴区人民医院心内科,北京102600

出　　处：《中国医药导报》2024年第14期58-60,69,共4页China Medical Herald

基　　金：首都卫生发展科研专项项目(首发2020-3-7122)。

摘　　要：目的 分析左西孟旦在急性心肌梗死(AMI)合并心力衰竭患者中的应用效果。方法 选取2018年1月至2022年11月北京市大兴区人民医院收治的106例AMI合并心力衰竭患者作为研究对象,按照随机数字表法将其分为两组,各53例。对照组采用标准化治疗,观察组同时联合左西孟旦治疗。比较两组治疗前后血清炎症因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、血流动力学水平[心指数(CI)、全心舒张末容积指数(GEDVI)、全身血管阻力指数(SVRI)]、心功能指标[左室射血分数(LVEF)、每搏输出量(SV)、B型尿钠肽(BNP)],及临床疗效和不良反应总发生率。结果 治疗后,两组hs-CRP、IL-6、TNF-α、GEDI、SVRI、BNP水平均低于治疗前,且观察组低于对照组(P<0.05);治疗后,两组CI、LVEF、SV水平均高于治疗前,且观察组高于对照组(P<0.05)。观察组临床疗效高于对照组(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 标准化治疗基础上联合左西孟旦治疗AMI合并心力衰竭能够有效缓解患者的炎症反应,稳定血流动力学,改善心功能和临床疗效,且无明显不良反应。Objective To analyze the application effect of Levosimendan in patients with acute myocardial infarction(AMI)complicated with heart failure.Methods A total of 106 patients with AMI complicated with heart failure admitted to Daxing District People’s Hospital in Beijing from January 2018 to November 2022 were selected as the research subjects.They were divided into two groups by a random number table method,with 53 patients in each group.The control group received standardized treatment,while the observation group received simultaneous treatment with Levosimendan.The serum inflammatory factors(high-sensitivity C-reactive protein[hsCRP],interleukin-6[IL-6],and tumor necrosis factor-α[TNF-α]),hemodynamic levels(cardiac index[CI],global end diastolic volume index[GEDVI],and systemic vascular resistance index[SVRI]),cardiac function indicators(left ventricular ejection fraction[LVEF],stroke volume[SV],and B-type natriuretic peptide[BNP])between two groups before and after treatment were compared,and the clinical efficacy and total incidence of adverse reactions between two groups were compared.Results After treatment,the hs-CRP,IL-6,TNF-α,GEDI,SVRI,and BNP of the two groups were all lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05);after treatment,the levels of CI,LVEF,and SV in both groups were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).The clinical efficacy of the observation group was higher than that of the control group(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion On the basis of standardized treatment,the combination of Levosimendan can effectively alleviate the inflammatory response,stabilize hemodynamics,improve heart function and clinical efficacy in patients with AMI complicated with heart failure,and there are no significant adverse reactions.

关 键 词：急性心肌梗死 心力衰竭 标准化治疗 左西孟旦 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]