左西孟坦治疗冠心病伴急性心力衰竭的疗效

Curative effect of levosimendan on patients with coronary artery disease complicated acute heart failure

目的:观察左西孟坦对冠心病急性心力衰竭的疗效,并分析其产生作用的机理。方法:本试验为随机、开放、对照临床研究,选取78例因冠心病而导致急性心力衰竭患者(NYHA分级Ⅱ至Ⅳ级)。病人被随机分为两组:对照组(41例,应用常规抗心衰治疗药物)和治疗组(37例,在常规抗心衰治疗基础上应用左西孟坦静脉滴注24h,剂量为0.1μg/kg.min)。追踪观察14d。全部入选病人在用药前和治疗10d左右时行床旁超声心动图检查,观察心脏收缩功能的变化。结果:治疗14d后,治疗组左室短轴缩短分数(FS)、每搏量(SV)、左室射血分数(LVEF)均显著高于治疗前(P均<0.01);且FS[(0.24±0.06)%],LVEF[(0.43±0.08)%]显著好于对照组(P分别<0.01,<0.05);对照组FS、SV、LVEF治疗前后均无显著差异(P>0.05)。结论:在常规抗心衰治疗的同时,应用左西孟坦可以明显改善急性心衰患者的收缩功能,具有较好的耐受性。

Objective： To observe the effect of levosimendan on patients with coronary artery disease （CAD） complicated acute heart failure and explore its mechanism.. Methods： The 78 CAD cases with acute heart failure （NYHA grade Ⅱ to grade Ⅳ） were selectedl All Patients were randomly divided into two groups： the control group （41 cases, treated with conventional treatment of heart failure） and the treatment group （37 cases, treated with conventional treatment of heart failure and levosimendan intravenous infusion）. Therapeutic duration was 14 days. All the selected patients before and 14 days after treatment were accepted bedside echocardiography to observe the change of fractional shortening （FS）, stroke volume （SV） and fractional shortening （LVEF）. Results： After 14 d treatment, the FS, SV and LVEF of treatment group increased （P〈0. 01 all）, and FS [ （0. 24±0. 06） %], LVEF [ （0. 42±0. 08）] were more than those of control group （P〈0. 01, P〈0. 05 respectively）. Conclusion： The levosimendan can significantly improved cardiac systolic function of CAD patients complicated with acute heart failure and with good tolerance.