摘要
目的:评估左西孟旦对直接经皮冠状动脉介入(PPCI)术后急性ST段抬高型心肌梗死(STEMI)合并心力衰竭患者血清可溶性ST2(sST2)水平的影响。方法:将87例PPCI术后前壁或广泛前壁STEMI合并心力衰竭(包括心原性休克)患者随机分为左西孟旦治疗组(研究组44例)和标准药物治疗组(对照组43例)。基线(d0)、第5天(d5)检测血清sST2水平,进行呼吸困难评分,并收集随访6个月主要不良心脏事件(MACE,包括心原性死亡与因心力衰竭再次住院)。结果:2组血清sST2基线水平比较差异无统计学意义。在d5时研究组血清sST2水平较对照组显著下降[(84. 5±28. 1) ng/mL vs (95. 7±22. 3) ng/mL,P <0. 05],呼吸困难评分较对照组显著改善[(3.3±0. 7)分vs (3. 0±0. 8)分,P <0. 05]。6个月临床随访时,研究组总体MACE发生率29. 5%,对照组37. 2%(P> 0. 05)。结论:左西孟旦可改善PPCI术后前壁或广泛前壁STEMI合并心力衰竭患者临床心功能,减低血清sST2水平。
Objective: To evaluate the effect of levosimendan on serum soluble ST2(sST2) levels in ST-segment elevation myocardial infarction(STEMI) patients complicated with heart failure after primary PCI(PPCI). Methods: A total of consequent 87 anterior or extensive anterior STEMI patients complicated with heart failure after PPCI were randomly divided into levosimendan group(study group,n = 44) and standard treatment group(control group,n = 43). Serum sST2 levels,dyspnea score and 6-month major adverse cardiac events(MACE,defined as cardiac death and rehospitalization for heart failure) were compared between two groups. Results: Baseline sST2 levels were not statistically different between two groups. On the day 5 after levosimendan treatment,sST2 levels were reduced significantly in the study group as compared with the control group [(84. 5 ± 28. 1) vs(95. 7 ± 22. 3) ng/mL,P < 0. 05]. There was a significantly larger improvement in dyspnea score in the study group than in the control group(3. 3 ± 0. 7 vs 3. 0 ± 0. 8,P < 0. 05). The total incidence of 6-month MACE showed no significant difference between the study group and the control group(29. 5% vs 37. 2%,P > 0. 05).Conclusions: Levosimendan could reduce serum sST2 levels and improve cardiac function in anterior or extensive anterior STEMI patients complicated with heart failure after PPCI.
作者
杨峰
徐承义
刘心甜
张李涛
吴明祥
刘成伟
YANG Feng;XU Cheng-yi;LIU Xin-tian;ZHANG Li-tao;WU Ming-xiang;LIU Cheng-we(Wuhan Asia Heart Hospital,Wuhan 430022,China)
出处
《内科急危重症杂志》
2018年第6期463-466,共4页
Journal of Critical Care In Internal Medicine
基金
武汉亚洲心脏病医院创新基金(No:2015CX3-A03)