左西孟旦与多巴酚丁胺对重症瓣膜病患者围术期心功能及预后的影响  

Effect of Levosimendan and Dobutamine on Perioperative Cardiac Function and Prognosis in Patients with Severe Valvular Disease

作　　者：郭裕良 袁昊尧 陈启明 彭晓鹏 GUO Yu-Liang;YUAN Hao-Yao;CHEN Qi-Ming;PENG Xiao-Peng(Department of Thoracic Surgery,The 1Oth Afiliated Hospital of Southern Medical University(Dongguan People's Hospital),Dongguan 523000,China;Department of Cardiac Macrovascular Surgery,The 10th Affiliated Hospital of Southern Medical University(Dongguan People's Hospital),Dongguan 523000,China)

机构地区：[1]南方医科大学第十附属医院(东莞市人民医院)胸外科,广东东莞523000 [2]南方医科大学第十附属医院(东莞市人民医院)心脏大血管外科,广东东莞523000

出　　处：《中国药物经济学》2025年第1期41-44,共4页China Journal of Pharmaceutical Economics

基　　金：东莞市社会发展科技项目任务书(20211800903252)。

摘　　要：目的探讨左西孟旦与多巴酚丁胺对重症瓣膜病患者围术期心功能及预后的影响。方法选取2023年1—12月于南方医科大学第十附属医院接受心脏瓣膜置换术的80例重症瓣膜病患者,按照不同治疗方法分为对照组与观察组,每组40例。两组术后均接受常规治疗,同时,对照组应用多巴酚丁胺治疗,观察组在对照组基础上联合左西孟旦治疗。比较两组心功能、炎症因子水平、不良心血管事件发生率及再住院率。结果治疗后,两组左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)及心输出量(CO)均较治疗前改善(P<0.05),且观察组优于对照组(P<0.05)。治疗后,两组血清白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α(TNF-α)水平均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。观察组不良心血管事件发生率及再住院率均低于对照组(P<0.05)。结论左西孟旦联合多巴酚丁胺治疗重症瓣膜病患者,相较于单独使用多巴酚丁胺治疗,能够有效改善围术期心功能,降低炎症因子水平,减少不良心血管事件发生率及再住院率,从而改善患者预后。Objective To explore the effects of levosimendan and dobutamine on perioperative cardiac function and prognosis in patients with severe valvular disease.Methods A total of 80 patients with severe valvular disease who received heart valve replacement in the 10th Affiliated Hospital of Southern Medical University from January to December 2023 were selected and divided into control group and observation group according to different treatment methods,with 40 cases in each group.Both groups received conventional treatment after surgery,meanwhile,the control group was treated with dobutamine,and the observation group was treated with levosimendan on the basis of the control group.Cardiac function,levels of inflammatory factors,incidence of adverse cardiovascular events and readmission rate were compared between the two groups.Results After treatment,left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and cardiac output(CO)in both groups were improved compared with those before treatment(P<0.05),and the observation group was better than the control group(P<0.05).After treatment,the serum levels of interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in both groups were lower than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The incidence of adverse cardiovascular events and re-hospitalization in the observation group were lower than those in the control group(P<0.05).Conclusion Levosimendan combined with dobutamine in the treatment of patients with severe valvular disease can more effectively improve perioperative cardiac function,reduce the level of inflammatory factors,and decrease the incidence of adverse cardiovascular events and rehospitalisation rate compared with dobutamine alone,thus improving the prognosis of patients.

关 键 词：左西孟旦 多巴酚丁胺 重症瓣膜病 心功能 预后 

分 类 号：R542.5[医药卫生—心血管疾病] R972[医药卫生—内科学]