左西孟旦和米力农对难治性心力衰竭患者的疗效比较

Curative effect of levosimendan and milrinone on refractory heart failure

目的观察左西孟旦和米力农对难治性心力衰竭患者血清氨基末端脑钠钛前体(NTproBNP)和左室射血分数(LVEF)的影响,比较二者治疗难治性心力衰竭的临床疗效和安全性。方法选取难治性心力衰竭患者共62例。随机分为观察组(n=31)和对照组(n=31),在两组均给予常规药物治疗基础上,观察组静脉滴注左西孟旦,对照组静脉滴注米力农。检测两组治疗前及治疗后1周血清氨基末端脑钠钛前体(NT-proBNP)水平,同期测定左心室射血分数(LVEF),并观察两组不良反应发生情况。结果治疗前两组患者血清NT-proBNP水平及LVEF值差异无统计学意义(P>0.05);治疗后与对照组比较,观察组患者血清NT-proBNP水平显著降低,差异有统计学意义(P<0.01),LVEF值显著升高,差异有统计学意义(P<0.01)。观察组有效率(80.6%)显著高于对照组(54.8%),差异有统计学意义(P<0.01)。观察组不良反应发生率(19.3%)显著低于对照组(29.0%),差异有统计学意义(P<0.01)。结论左西孟旦在治疗难治性心力衰竭的临床疗效和安全性优于米力农。

Objective To observe the effect of levosimendan and milrinone on serum N-terminal pro-B-type natriuretic peptide （NT-proBNP） level and left ventricular ejection fraction（LVEF）in patients with refractory heart failure and to compare the clinical efficacy and safety of levosim endan and milrinone on refractory heart failure. Methods Choosing 62 refractory heart failure patients and randomly dividing them into two groups：observation group （n=31） and control group （n=31）. Both of them were administered with conventional therapy, the observation group were given levosimendan. The control group were given milrinone and observed the changes of serum N-terminal pro-B-type natriuretic peptide （NT-proBNP） levels and LVEF. The incidence rate of adverse drug reaction in the two groups were observed. Results The levels of NT-proBNP and LVEF were significantly different between the two groups after treatment（P〈0.01） though no significant difference was found before treatment（P〉0.05）. Compared with control group, observation group had a significant improvement in LVEF（P〈0.01）, and significant decrease in NT-proBNP level（P〈0.01）. After treatment, the totally therapeutic effect was better in observation group than control group（P〈0.01）.The incidence rate of adverse drug reaction in the observation group（19.3%）was much lower than that in the control group（29.0%）（P〈0.01）. Conclusion Levosimendan has an exact effect on refractory heart failure. It is better than milrinone at efficiency and safety.