左西孟旦治疗射血分数正常充血性心力衰竭患者的短期疗效

Short-term effects of levosimendan in patients with heart failure and normal ejection fraction

目的:探讨左西孟旦治疗射血分数正常充血性心力衰竭(HFnEF)患者的短期疗效。方法:入选HFnEF患者80例,随机分为常规治疗组(血管紧张素转换酶抑制剂/血管紧张素受体阻断剂+利尿剂+硝酸酯类扩血管药)和左西孟旦组(常规治疗的基础上加用左西孟旦),每组各40例。所有患者于入院时和用药7 d后测定N末端B型利钠肽原(NT-proBNP)血浆水平、心功能分级、静息及分级小剂量多巴酚丁胺负荷后左室收缩功能指标:左室射血分数(LVEF)、高峰射血率(PER)、高峰射血时间(TPER),并计算其最大变化率。结果:治疗后两组NT-proBNP血浆水平均较治疗前明显下降,左西孟旦组治疗后NT-proBNP血浆水平低于常规治疗组治疗后(P<0.05);左西孟旦组显效率和总有效率高于常规治疗组,无效率低于常规治疗组(P<0.05);左西孟旦组治疗后LVEF、PER及TPER的最大变化率均较治疗前明显增加,且左西孟旦组治疗后LVEF的最大变化率明显高于常规治疗组(P<0.05)。结论:左西孟旦对HFnEF患者短期疗效良好,能降低患者血浆NT-proBNP水平,改善左心室收缩功能。

Objective：To investigate short-term effects of levosimendan in patients with heart failure and normal ejection fraction（HFnEF）.Methods：A total of 80 patients with HFnEF were recruited and randomly devided into group A （conventional therapy only） and group B （levosimendan plus conventional therapy）.The serum levels of N-terminal pro-B-type natriuretic peptide （NT proBNP）,clinical efficacy and left ventricular systolic function indexes including left ventricular ejection fraction（LVEF）,peak ejection rate（PER）,peak ejection time（TPER） and its maximal change rate which were tested by radionuclide ventriculography at resting and dobutamine stress,were measured before and after treatment for 7 days.Results：Plasma NT-proBNP levels were significantly decreased after treatment in both groups（P＜0.05）.The degree of plasma NT-proBNP concentration in group B was decreased significantly compared to group A（P＜0.05）.Both significant effective rate and total effective rate in group B were higher than those in group A（P＜0.05）.The maximal change rate of LVEF,PER and TPER was significantly different before and after treatment in group B （P＜0.05）.After treatments the maximal change rate of LVEF in group B was higher than that in the group A （P＜0.05）.Conclusion：Short-term administratin of levosimendan can improve heart function of HFnEF patients by reducing plasma NT-proBNP.