左西孟旦治疗急性左心衰的临床观察

发布时间：2018-06-03 18:09

本文选题：急性左心衰 + 左西孟旦　；参考：《中国药房》2017年32期

【摘要】：目的:探讨左西孟旦治疗急性左心衰的疗效及安全性,以及对左心功能指标和血清标志物的影响。方法:选取2014年1月-2015年12月解放军第251医院收治的急性左心衰患者110例为研究对象,按照随机数字表法分为对照组(53例)和观察组(57例)。两组患者均给予常规药物治疗。对照组患者在常规治疗基础上给予盐酸多巴胺注射液或盐酸多巴酚丁胺注射液强心;观察组患者在常规治疗基础上给予左西孟旦注射液初始负荷剂量10μg/kg+0.9%氯化钠注射液50 m L,ivgtt(10 min),之后改微量泵泵注,速率0.1μg/(kg·min),持续给药24 h。两组患者均连续治疗7 d。观察两组患者临床疗效,治疗前后的左心功能指标[峰射血率(PER)、峰充盈率(PFR)、左室射血分数(LVEF)和左室短轴缩短率(LVSF)]水平、血清标志物[N-末端脑钠肽前体(NT-pro BNP)和半乳糖凝集素3(Gal-3)]水平,并记录不良反应发生情况。结果:两组患者因死亡脱落2例(每组各1例),最终纳入统计的合格病例数为108例,其中对照组52例、观察组56例。观察组患者的临床总有效率(94.64%)高于对照组(86.54%),但差异无统计学意义(P0.05)。治疗前,两组患者左心功能指标和血清标志物水平比较,差异均无统计学意义(P0.05)。治疗后,两组患者上述左心功能指标水平均显著升高,且观察组的LVEF和LVSF显著高于对照组,差异均有统计学意义(P0.05);两组患者NTpro BNP和Gal-3均显著降低,且观察组显著低于对照组,差异均有统计学意义(P0.05)。两组患者治疗过程中均未见明显的不良反应发生。结论:左西孟旦治疗急性左心衰疗效与多巴胺相似,但有助于增强左心泵血功能,降低心衰标志物水平,且安全性较高。
[Abstract]:Objective: to investigate the efficacy and safety of levosimendan in the treatment of acute left heart failure and its effect on left ventricular function and serum markers. Methods: 110 patients with acute left heart failure admitted from January 2014 to December 2015 were divided into control group (53 cases) and observation group (57 cases). Both groups were given routine drug therapy. The patients in the control group were treated with dopamine hydrochloride injection or dobutamine hydrochloride injection on the basis of routine treatment. On the basis of routine treatment, patients in the observation group were given the initial loading dose of 10 渭 g/kg 0.9% sodium chloride injection 50 mL iv GTT for 10 mins, then micropump injection at the rate of 0.1 渭 g/(kg min for 24 h. The patients in both groups were treated continuously for 7 days. To observe the clinical effect, left ventricular function index [peak ejection rate, peak filling rate, left ventricular ejection fraction (LVEF) and left ventricular short axis shortening rate (LVSFs)] before and after treatment, and to observe the level of left ventricular ejection rate (PERR), peak filling rate (PEF), left ventricular ejection fraction (LVEF) and left ventricular shortening rate (LVSF). Serum markers [NT-pro BNPs] and galactose agglutinin (Gal-3) were measured and the adverse reactions were recorded. Results: there were 2 cases (1 case in each group), 108 eligible cases were included in the statistics, 52 cases in the control group and 56 cases in the observation group. The total effective rate of the patients in the observation group (94.64) was higher than that in the control group (86.54), but the difference was not statistically significant (P 0.05). Before treatment, there was no significant difference in left ventricular function and serum markers between the two groups (P 0.05). After treatment, the level of left ventricular function in the two groups increased significantly, and the LVEF and LVSF in the observation group were significantly higher than those in the control group (P 0.05), the NTpro BNP and Gal-3 in the two groups were significantly lower than those in the control group, and that in the observation group was significantly lower than that in the control group. The difference was statistically significant (P 0.05). There were no obvious adverse reactions in both groups. Conclusion: the therapeutic effect of levosimendan on acute left heart failure is similar to that of dopamine, but it can enhance left ventricular pump function and decrease the level of markers of heart failure.
【作者单位】：张家口学院医学院;解放军第251医院重症医学科;
【分类号】：R541.6

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