二维斑点追踪技术对左西孟旦治疗老年急性失代偿心力衰竭患者的疗效评价

发布时间：2018-03-09 13:42

本文选题：心力衰竭　切入点：左西孟旦　出处：《山东医药》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨左西孟旦治疗老年急性失代偿性心力衰竭患者的临床疗效及二维斑点追踪技术对疗效的评价作用。方法选取大于60岁急性失代偿性心力衰竭患者62例,随机分成观察组和对照组各31例。两组在接受心衰常规药物治疗(包括洋地黄、利尿剂、硝普钠或硝酸酯类药物等)的基础上,观察组用左西孟旦注射液持续静滴24 h,对照组用多巴胺持续静滴24 h。用药前和用药后24 h行常规超声心动图检测左室舒张末内径(LVEDD)和左室射血分数(LVEF)。同时采用二维斑点追踪技术在心尖四腔、三腔、二腔长轴切面观获得基底段、中间段、心尖段及整体应变峰值,在左室基底部、心尖部短轴切面观获得左心室心尖部旋转角度峰值(PAR)、基底部旋转角度峰值(PBR)及左室整体旋转角度峰值(PTW),比较两组间各指标变化情况。结果两组治疗前后LVEDD、LVEF差异均无统计学意义(P均0.05)。观察组治疗后心脏各部位应变峰值以及左室旋转参数PAR、PBR、PTW差异有统计学意义(P均0.05)。结论对老年急性失代偿性心力衰竭患者,左西孟旦能快速、有效地改善心脏收缩功能,二维斑点追踪技术能早期定量反映心脏收缩功能的变化。
[Abstract]:Objective to investigate the clinical efficacy of levosimendan in the treatment of elderly patients with acute decompensated heart failure and to evaluate the efficacy of two-dimensional speckle tracing technique. Methods 62 patients aged more than 60 years with acute decompensated heart failure were selected. The two groups were randomly divided into two groups: 31 cases in the observation group and 31 cases in the control group. The two groups were treated with conventional drugs for heart failure (including digitalis, diuretics, sodium nitroprusside or nitrates). Left ventricular end-diastolic diameter (LVEDDD) and left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were measured by routine echocardiography before and 24 hours after administration of dopamine. The dimensional speckle tracing technique was used in apical four-chamber, The peak values of the basal segment, the middle segment, the apical segment and the global strain were obtained at the base of the left ventricular base. The peak value of left ventricular apex rotation angle (PARN), base base rotation angle peak value (PBR) and left ventricular global rotation angle peak value (PTWN) were obtained by apical short axis sectional view. Results the changes of each index were compared between the two groups before and after treatment. There was no significant difference between the two groups (P < 0.05). There were significant differences in the peak strain of each part of the heart and the left ventricular rotation parameters (paraphora) in the observation group (P < 0.05). Conclusion there is a significant difference in the aged patients with acute decompensated heart failure. Levosimendan can improve cardiac systolic function quickly and effectively. Two-dimensional speckle tracing technique can reflect the change of cardiac systolic function quantitatively in early stage.
【作者单位】：广西医科大学第四附属医院;
【基金】：广西壮族自治区卫生厅自筹经费科研项目(Z2015140)
【分类号】：R541.6

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