左西孟旦对老年慢性心力衰竭急性加重患者的临床疗效及心功能影响  

Clinical Efficacy and Impact on Cardiac Function of Levosimendan in Elderly Patients with Acute Exacerbation of Chronic Heart Failure

作　　者：杨帆 雷鸣 YANG Fan;LEI Ming(Pharmacy Center of Shandong Public Health Clinical Center,Jinan 250100,China;Department of Pharmacy,Health Center of Erqi New Village Sub-district Office,Shizhong District,Jinan City(Community Health Service Center,Sili Village Sub-district Office,Shizhong District,Jinan City),Jinan 250002,China)

机构地区：[1]山东省公共卫生临床中心药学中心,山东济南250100 [2]济南市市中区二七新村街道办事处卫生院(济南市市中区四里村街道办事处社区卫生服务中心)药剂科,山东济南250002

出　　处：《中华灾害救援医学》2025年第2期192-195,199,共5页Chinese Journal of Disaster Medicine

摘　　要：目的探讨对于老年慢性心力衰竭急性加重患者,左西孟旦抗心力衰竭的临床疗效及对患者心功能的影响。方法选取2021年3月至2024年3月期间在山东省公共卫生临床中心就诊的100例老年慢性心力衰竭急性加重患者,采用随机数字表法将其分为研究组和对照组,每组50例。对照组患者接受抗心力衰竭基础治疗及重组人脑利钠肽治疗,研究组患者在对照组基础治疗上加用左西孟旦。比较两组患者的临床疗效、心功能指标、血清学指标、步行距离及不良反应情况。结果与对照组相比,研究组患者的临床总有效率明显更高(P<0.05)。治疗后,两组患者左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心脏指数(CI)、每搏输出量(SV)水平均较治疗前明显升高(P<0.001),相较于对照组,研究组患者LVEF、SV、CI水平更高(P<0.001)。两组患者治疗后LVEDD水平均较治疗前明显降低(P<0.001),且研究组患者治疗后的LVEDD水平较对照组更低(P<0.001)。治疗后,两组患者血清学指标氨基末端脑钠肽前体(NT-proBNP)、白细胞介素-6(IL-6)、超敏-C反应蛋白(hs-CRP)、心肌肌钙蛋白I(cTnI)水平均较治疗前明显降低(P<0.001),且研究组患者NTproBNP、cTnI、hs-CRP、IL-6水平较治疗组更低(P<0.001)。治疗后,两组患者6MWT距离均较治疗前明显增加(P<0.001),相较于对照组,研究组患者6MWT距离增加更明显(P<0.001)。两组患者的不良反应总发生率差异无统计学意义(P>0.05)。结论对于老年慢性心力衰竭急性加重患者,予以左西孟旦辅助治疗可提高患者的临床疗效,改善患者的心功能,保护心肌细胞,安全性高。Objective This study aims to investigate the clinical efficacy of levosimendan in treating elderly patients with acute exacerbation of chronic heart failure and its impact on cardiac function.Methods A total of 100 elderly patients with acute exacerbation of chronic heart failure who were treated at the Shandong Provincial Public Health Clinical Center from March 2021 to March 2024 were selected.Using a random number table method,patients were divided into two groups:the study group and the control group,with 50 patients in each group.The control group received standard heart failure treatment along with recombinant human brain natriuretic peptide therapy,while the study group received levosimendan in addition to the treatment provided to the control group.Clinical efficacy,cardiac function indicators,serological markers,walking distance,and adverse reactions were compared between the two groups.Results The overall clinical efficacy rate in the study group was significantly higher than that in the control group(P<0.05).After treatment,both groups exhibited significant increases in left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),cardiac index(CI),and stroke volume(SV)compared to baseline values(P<0.001).The study group demonstrated higher levels of LVEF,SV,and CI than the control group(P<0.001).Additionally,both groups showed a significant reduction in LVEDD after treatment(P<0.001),with the study group having a lower LVEDD compared to the control group(P<0.001).Post-treatment serological markers,including amino-terminal pro-B-type natriuretic peptide(NT-proBNP),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),and cardiac troponin I(cTnI),were significantly lower than baseline levels in both groups(P<0.001),with the study group exhibiting reduced levels of NT-proBNP,cTnI,hs-CRP,and IL-6 compared to the control group(P<0.001).The 6-minute walk test(6MWT)distance significantly increased in both groups post-treatment(P<0.001),with a more pronounced improvement ob

关 键 词：心力衰竭 左西孟旦 心功能 

分 类 号：R541.61[医药卫生—心血管疾病]