阴艳萍 江建军 葛卫力



左西孟旦治疗充血性心力衰竭的疗效分析

阴艳萍 江建军 葛卫力

【摘要】目的 探讨左西孟旦注射液治疗充血性心力衰竭患者的疗效及安全性。方法 将60例充血性心力衰竭患者随机分为对照组即常规治疗组，左西孟旦组即常规治疗+左西孟旦，每组各30例。对照组予利尿剂、硝酸酯类、洋地黄类、ACEI/ARB类等常规治疗，左西孟旦组在此基础上加用左西孟旦，7 d后比较两组BNP（B型利钠肽）、LVEF（左室射血分数）、CI（心指数）、有效率及不良反应发生率。结果 治疗7 d后，两组BNP、LVEF、CI较治疗前均有改善（P＜0．05），与对照组相比，左西孟旦组BNP下降，LVEF、CI升高（P＜0．05）。左西孟旦组总有效率（90．0%）较对照组（66．7%）差异有统计学意义；两组患者在治疗期间未发现明显不良反应。结论 左西孟旦可有效改善充血性心衰患者的心功能指标及BNP水平。

【关键词】左西孟旦；充血性心力衰竭；B型利钠肽

Objective To explore the curative effect and safety of levosimendan on patients of congestive heart failure． Methods 60 patients with congestive heart failure were randomly divided into control group（a group with conventional treatment）and leosimendan group（a group with conventional treatment plus leosimendan ），30 cases in each group． Before and after 7days treatment，the serum level of BNP，LVEF （left ventricular ejection fraction），CI（heart index），effective rate and incidence of adverse reactions were observed． Results After 7 days treatment，BNP，LVEF and CI of both groups were all improved（P＜0．05）． Compared with the control group，the BNP of leosimendan group were obviously lower，meanwhile the LVEF，CI of leosimendan group were obviously higher（P＜0．05）． The total effective of leosimendan group（90．0%）were higher than those of the control group（66．7%）． There were no obvious adverse reactions during treatment in the two groups． Conclusion Levosimendan can effectively improve the cardiac function indexes and the level of BNP in patients with congestive heart failure．

【Key words】 Levosimendan，Congestive heart failure，BNP

充血性心力衰竭是各种病因所致心脏疾病的终末阶段，表现为心功能减退及心排血量下降而出现的综合征。成人充血性心衰的病因主要是冠心病、高血压、瓣膜病和扩张型心肌病。随着冠心病及高血压病的发病人群逐渐增多，充血性心力衰竭的发病率也呈逐年上升趋势。正性肌力药物是心力衰竭治疗中的重要组成部分，其中新型Ca2+增敏剂左西孟旦在相关指南中均有建议。左西孟旦可增强心肌收缩力、改善血流动力学效应、抗心肌缺血、无明显致恶性心律失常作用等优点。本研究通过观察充血性心力衰竭患者治疗前后心功能改善情况，进一步评价其疗效及安全性。……