左西孟旦治疗老年重度充血性心力衰竭的临床观察

CLINICAL OBSERVATION ON THE CURATIVE EFFECT OF LEVOSIMENDAN ON SENILE SEVERE CONGESTIVE HEART FAILURE

目的探索左西孟旦(Levosimendan)治疗老年重度充血性心力衰竭(CHF)临床疗效与安全性。方法将年龄>60岁的重度CHF患者80例随机分为观察组和对照组各40例,给予对照组患者常规药物治疗(如洋地黄类、血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗药、硝酸酯类、利尿剂等),并充分抗感染、限盐、纠正诱发因素等;给予观察组患者常规治疗的同时加用左西孟旦静脉注射。观察两组患者的治疗效果、左室射血分数的改善情况及不良反应的发生率。结果观察组的治疗有效率及总有效率明显高于对照组(P<0.01)。观察组左室射血分数提高的幅度明显要高于对照组(P<0.01)。观察组患者的不良反应发生率(7.5%)低于对照组(15.0%)(P<0.01)。结论左西孟旦可有效提高老年重度充血性心力衰竭的射血分数,疗效高且有较好的安全性和耐受性。

Objective To explore the clinical effect and safety of using levosimendan to treat senile severe congestive heart failure （CHF）. Methods 80 cases of senile severe CHF were randomly divided into the observation group and the contrast group. The contrast group was treated with such regular drugs as digitalis, angiotensin converting enzyme inhibitor, angiotensin II receptor antagonistic drug, nitrate and diuretic in addition to anti-infection method, salt restriction and the correction of causative factor, while the observation group was treated with the intravenous injection of levosimendan in addition to regular treatment. The curative effect, the improvement in LVEF and the incidence of adverse effect in the two groups were observed and compared. Results s The effective rate and the total effective rate were found significantly higher in the observation group than those in the contrast group（ P 〈 0.01）. The LVEF was improved significantly higher in the observation group than that in the contrast group（ P 〈0. 01）. The incidence of adverse effect in the observation group（7.5%）was much lower than that（15. 0%）in the contrast group （P 〈0. 01）. Conclusion.The use of levosimendan can effectively promote senile severe CHF, improve clinical symptom and have good safety and drug tolerance.