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【摘要】 目的：探討左西孟旦对慢性心力衰竭患者心室重塑及心脏储备功能的影响。方法：选取2018年1月-2020年1月本院收治的慢性心力衰竭患者86例为研究对象。按照随机数字表法分为试验组（常规治疗+左西孟旦治疗）和对照组（常规治疗），各43例。分别于治疗前后测定两组心室重塑、心脏储备功能、炎症因子等指标，比较两组疗效与安全性。结果：治疗前，两组心室重塑、心脏储备功能、炎症因子等指标比较，差异均无统计学意义（P>0.05）;治疗后，试验组心室重塑、心脏储备功能、炎症因子等指标均优于对照组（P<0.05）。治疗前，两组Lee氏心衰积分比较，差异无统计学意义（P>0.05）;治疗后，试验组Lee氏心衰积分低于对照组（P<0.05），且试验组总有效率高于对照组（P<0.05）。两组治疗期间出现的不良症状均较轻微，经对症处理后缓解，两组安全性比较，差异无统计学意义（P>0.05）。结论：左西孟旦在慢性心力衰竭患者治疗中的效果较好，可有效改善其心室重塑与心脏储备功能指标，抑制炎症反应，且安全性较好，应用价值较高。

【关键词】 左西孟旦 慢性心力衰竭 心室重塑 心脏储备功能

[Abstract] Objective： To investigate the effect of Levosimendan on ventricular remodeling and cardiac reserve function in patients with chronic heart failure. Method： A total of 86 patients with chronic heart failure in our hospital from January 2018 to January 2020 were selected as the research objects. They were randomly divided into the experimental group （conventional treatment + Levosimendan treatment） and the control group （conventional treatment）， 43 cases in each group. The ventricular remodeling， cardiac reserve function and inflammatory factors of two groups were measured before and after treatment， and the efficacy and safety of two groups were compared. Result： Before treatment， there were no significant differences in ventricular remodeling， cardiac reserve function and inflammatory factors between two groups （P>0.05）. After treatment， the indexes of ventricular remodeling， cardiac reserve function and inflammatory factors in the experimental group were better than those in the control group （P<0.05）. Before treatment， there was no significant difference in Lees heart failure score between two groups （P>0.05）; after treatment， Lees heart failure score of the experimental group was lower than that of the control group （P<0.05）， and the total effective rate of the experimental group was higher than that of the control group （P<0.05）. The adverse symptoms of two groups were mild and relieved after symptomatic treatment， there was no significant difference in safety between two groups （P>0.05）. Conclusion： Levosimendan in the treatment of patients with chronic heart failure has good effect， can effectively improve its ventricular remodeling and cardiac reserve function index， inhibit inflammatory reaction， and has good safety and high application value.

[Key words] Levosimendan Chronic heart failure Ventricular remodeling Cardiac reserve function

First-authors address： Fengcheng Hospital of Traditional Chinese Medicine， Fengcheng 118100， China

doi：10.3969/j.issn.1674-4985.2021.06.002

慢性心力衰竭不是一个独立的疾病，而是各种心脏相关疾病发展的终末阶段，是指心脏结构发生不可逆的重塑，且病情容易反复甚至恶化，好发于中老年，而且随着社会的发展，我国人口老龄化程度越来越严重，慢性心力衰竭的发病率呈现出逐年升高的趋势，严重影响患者的生活[1-3]。目前该疾病多给予利尿剂、β受体阻滞剂、血管紧张素转换酶抑制剂、硝酸酯类血管扩张剂等常规治疗，但效果不是十分理想。有研究指出，神经内分泌系统激活导致心肌重构与慢性心力衰竭的发生发展密切相关，且心脏储备是心脏功能的重要评估指标，如舒张期、收缩期的储备等[4]。左西……