左西孟坦治疗急性心肌梗死合并心力衰竭患者的疗效研究

Therapeutic effect of levosimendan on patients with acute myocardial infarction complicated heart failure

目的:评价左西孟坦治疗急性心肌梗死(AMI)合并充血性心力衰竭(CHF)的临床疗效。方法:选择58例确诊AMI后一周内并发CHF患者,采用随机数字法分为左西孟旦组(30例,予以左西孟坦治疗)和多巴胺对照组(28例,给予多巴胺治疗)。观察两组治疗前后临床指标及N末端B型利钠肽前体(NT-proBNP)等指标的变化。结果:治疗前两组各指标均无显著差异(P>0.05);与治疗前及多巴胺组治疗后比较,左西孟坦组治疗后心率[(120.91±11.78)次/min、(122.67±9.01)次/min比(114.93±10.76)次/min]、呼吸频率[(26.00±3.13)次/mmin、(23.18±2.38)次/min比(21.47±2.67)次/min]、呼吸困难程度评分[(2.50±0.90)分、(2.07±0.77)分比(1.70±0.59)分]、肺毛细血管楔压[(22.50±2.57)mmHg、(19.57±2.87)mmHg比(16.80±2.39)mmHg]、NT-proBNP水平[(1207.5±95.6)pg/ml、(1097.85±87.6)pg/ml比(729.60±62.9)pg/ml]均显著下降(P<0.05或<0.01),LVEF[(38.40±3.09)%、(41.57±3.10)%比(44.10±3.94)%]、心脏指数[(2.09±0.27)L·min^(-1)·m^(-2)、(2.24±0.27)L·min^(-1)·m^(-2)比(2.40±0.29)L·min^(-1)·m^(-2)]显著提高(P<0.05或P<0.01)。结论:左西孟坦可以短期内明显改善急性心肌梗死患者心力衰竭病情。

Objective： To evaluate therapeutic effect of levosimendan on acute myocardial infarction （AMI） complicated congestive heart failure （CHF）. Methods： A total of 58 patients, who were complicated with CHF within one week after AMI diagnosis, were randomly divided into levosimendan group （n = 30, received levosimendan therapy） and dopamine control group （n = 28, received dopamine therapy） using random number table method. Clinic indexes, level of N terminal pro brain natriuretic peptide （NT-proBNP） etc. were observed in two groups before and after treatment. Results.. There were no significant differences in all indexes between two groups before treatment （P 〈0.05; compared with before treatment and dopamine group after teatment, there were significant decrease in heart rate [ （120. 91 ± 11.78） times/min, （122.67 ± 9.01） times/min vs. （114.93 ± 10.76） times/mini, respiratory frequency [ （26.00 ± 3.13） times/rain, （23. 18 ± 2.38） times/min vs. （21.47 ± 2.67） times/mini, score of dyspnea degree [ （2.50 ± 0. 90） scores, （2. 07 ± 0.77） scores vs. （1.70 ± 0.59） scores], pulmonary capillary wedge pressure [PCWP, （22.50 ± 2.57） mmHg, （19.57 ± 2.87） mmHg vs. （16. 80 ± 2.39） mmHg] and level of NT-proBNP E （1207.5 ± 95. 6） pg/ml, （1097.85 ± 87.6） pg/ml vs. （729.60 ± 62.9） pg/ml] （P〈0.05 or P〈0.01）, and significant increase in LVEF F （38. 40 ± 3.09） %, （41.57 ± 3.10） % vs. （44. 10 ± 3.94） %1 and cardiac index [CI, （2. 09 ± 0.27） L ·min^-1·m^-2, （2.24±0.27） L·min^-1·m^-2 vs. （2.40±0.29） L ·min^-1·m^-2] in levosimendan group after treatment, P〈0. 05 or P〈0.01. Conclusion.. Levosimendan can significantly improve patient＇s condition of heart failure in patients with acute myocardial infarction.