左西孟旦注射液在老年慢性心力衰竭中的应用疗效及安全性分析

黄志文+彭春玲+田丽红

[摘要] 目的 評价左西孟旦治疗老年慢性心力衰竭的临床疗效以及安全性。方法 将2016年2月～2017年2月期间于我院心内科住院治疗的72例慢性心力衰竭患者随机分为对照组以及左西孟旦组，每组各36例患者，对照组给予洋地黄、呋塞米以及血管紧张素转换酶抑制剂（ACEI）或血管紧张素Ⅱ受体阻滞剂（ARB）等常规抗心力衰竭的药物治疗，而左西孟旦组患者在对照组治疗的基础上加用左西孟旦注射液，观察两组患者治疗前与治疗后一周时的血压、心率等指标的变化。结果 与治疗前相比，两组患者治疗一周后的左室舒张末内径（LVEDd）、左室收缩末内径（LVESd）减小，脑利钠肽前体（pro-BNP）水平降低，心功能好转，心脏指数（CI）以及左室射血分数（LVEF）增加，差异具有统计学意义（P<0.05）。此外，与对照组相比，左西孟旦组患者治疗一周后的血压、心率呈下降趋势，心功能好转，pro-BNP下降，24h尿量显著增加，LVEDd以及LVESd变小，LVEF以及CI增加，差异同样具有统计学意义（P<0.05）。左西孟旦组治疗的有效率为72.2%，显著高于对照组55.5%，并且两组患者均无严重的不良反应发生。结论 左西孟旦治疗老年慢性心力衰竭的临床疗效显著，安全性较高，值得推广应用。

[关键词] 左西孟旦；心力衰竭；疗效；安全性

[中图分类号] R541.6 [文献标识码] A [文章编号] 2095-0616（2017）13-63-04

[Abstract] Objective To evaluate the clinical curative effect and safety of levosimendan in treatment of elderly patients with chronic heart failure. Methods 72 patients with chronic heart failure who were hospitalized in department of cardiovascular internal medicine in our hospital from February 2016 to February 2017 were randomly divided into the control group and the levosimendan group， with 36 in each. The control group was given routine anti-heart-failure drug treatment such as digitalis， furosemide， angiotensin-converting enzyme inhibitor（ACEI）， angiotensin Ⅱ receptor blockers（ARB） and so on. Patients in the levosimendan group were additionally used levosimendan injections at basis of the control group. Changes of blood pressure， heart rate and other indexes before treatment and 1 week after treatment of patients in two groups were observed. Results Compared with before treatment， left ventricular end diastolic diameter（LVEDd）， left ventricular end-systolic dimension（LVESd） and pro-brain natriuretic peptide（pro-BNP） level of 1 week after treatment were decreased. Cardiac function was improved. Cardiac index（CI） and left ventricular ejection fraction（LVEF） were increased. Differences were significant and there were statistical significance（P<0.05）. In addition， compared with the control group， blood pressure and heart rate of 1 week after treatment of patients in the levosimendan group were decreased. Cardiac function was improved and pro-BNP was decreased. 24h urine volume was significantly increased. LVEDd and LVESd were smaller while LVEF and CI were increased. Differences were also statisticvcally significant（P<0.05）. The effective rate of levosimendan was 72.2%， which was significantly higher than that of the control group（55.5%）. There was no severe adverse reaction in patient of two groups. Conclusion Levosimendan in treatment of elderly patients with chronic heart failure has significant clinical curative effect and safety， which is worthy of promotion and application.

[Key words] Levosimendan； Heart failure； Curative effect； Safety

心力衰竭是各类心脏疾患的终末期阶段表现，临床发病率很高，成为如今我国重要的心血管疾患之一[1]，病因主要以冠状动脉粥样硬化性疾病为主，其次原因为高血压，同时心力衰竭的病死率也相应高于其他心血管疾患，对于患者的危害较大。而目前临床针对心力衰竭的治疗主要为洋地黄、利尿剂、血管紧张素转化酶抑制剂（ACEI）以及血管紧张素Ⅱ受体阻滞剂（ARB）等常规抗心力衰竭的药物，但是效果却并不显著[2]，本研究在常规治疗的基础上加用了左西孟旦注射液，通过研究对比两组患者的疗效以及各项指标数据，探讨左西孟旦的疗效以及应用安全性，现报道如下。……