左西孟旦治疗不同病因致难治性心力衰竭的疗效及安全性

发布时间：2018-03-24 00:14

本文选题：左西孟旦　切入点：难治性心力衰竭　出处：《中国老年学杂志》2017年07期

【摘要】：目的评价左西孟旦治疗不同病因致难治性心力衰竭的疗效及安全性。方法选取天津市胸科医院CICU收治的难治性心力衰竭患者170例,根据原发疾病不同分为扩张型心肌病(DCM)组(n=40)和缺血性心肌病(ICM)组(n=130);两组均在心力衰竭常规治疗效果不佳的基础上加用左西孟旦注射液,综合评价左西孟旦治疗不同病因致难治性心力衰竭的疗效和安全性。结果左西孟旦可以明显改善难治性心力衰竭患者左室舒张末期内径(LV)、左室射血分数(LVEF)、心功能NYHA分级水平、肺动脉压(PAP)和N末端B型钠尿肽(NT-pro BNP)水平,且对于上述指标的改善程度ICM组明显均优于DCM组(P0.05);两组患者用药前后电解质(K~+、Na~+、Cl~-)、肾功能〔尿素氮(BUN)、肌酐(Cr)〕、肝功能〔谷丙转氨酶(ALT)、谷草转氨酶(AST)〕比较差异无统计学意义(P0.05);两组患者用药后6、24、48 h心率、呼吸、血氧饱和度分别与用药前相比,差异无统计学意义(P0.05);两组患者用药后6、24、48 h的平均动脉压明显低于用药前(P0.05)。结论在常规治疗的基础上加用左西孟旦注射液治疗难治性心力衰竭疗效确切;左西孟旦注射液对ICM患者的疗效优于DCM组;左西孟旦注射液不良反应少,安全性良好。
[Abstract]:Objective to evaluate the efficacy and safety of levosimendan in the treatment of refractory heart failure caused by different etiology. Methods 170 patients with refractory heart failure treated by CICU in Tianjin chest Hospital were selected. According to the primary diseases, they were divided into two groups: dilated cardiomyopathy group (DCM) group (n = 40) and ischemic cardiomyopathy group (ICM) group (n = 130). Both groups were treated with levosimendan injection on the basis of poor routine treatment of heart failure. Results the left ventricular end-diastolic diameter (LVV), left ventricular ejection fraction (LVEF) and cardiac function (NYHA) were significantly improved in patients with refractory heart failure. Pulmonary artery pressure (PAP) and N-terminal B-type natriuretic peptide (NT-pro BNPs) were detected. The improvement degree of the above indexes in ICM group was obviously better than that in DCM group P0.050.There was no statistical difference between the two groups in electrolyte K ~ + Na ~ + Cl-P, renal function (urea nitrogen bun, creatinine, creatinine), liver function (alanine aminotransferase) and glutamic oxaloacetic transaminase (ASTT). The heart rate of the patients in the two groups was 6: 24 hours, 48 hours after the treatment. Respiratory and blood oxygen saturation were compared with those before medication. The mean arterial pressure in the two groups was significantly lower than that in the control group (P 0.05). Conclusion on the basis of routine therapy, the effect of levosimendan injection on refractory heart failure is definite. The curative effect of levosimendan injection on ICM patients was better than that of DCM group, and the safety of levosimendan injection was better than that of levosimendan injection.
【作者单位】：天津医科大学研究生院;天津胸科医院CICU科;
【基金】：天津市卫计委攻关项目(14KG127)
【分类号】：R541.6

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