左西孟旦治疗急性心肌梗死并发心源性休克54例疗效评价

Levosimendan for Treating Acute Myocardial Infarction Complicated by Cardiogenic Shock in 54 Cases

目的探讨左西孟旦治疗急性心肌梗死并发心源性休克的临床疗效及安全性。方法将2013年1月至2015年1月收治的急性心肌梗死并发心源性休克患者108例随机分为对照组和观察组,各54例。两组患者均给予吸氧、补充血容量、正性肌力药物、升压药物、溶栓治疗等基础治疗,包括去甲肾上腺素治疗等。对照组在此基础上给予多巴酚丁胺微泵静脉注射,观察组给予左西孟旦微泵静脉注射,两组患者治疗时间均为2周。结果两组患者治疗0.5,1,2,24 h以及治疗后2周的血压均高于治疗前,心率均低于治疗前,且观察组各时间点血压及心率的改善情况均显著优于对照组(P<0.05)。治疗2周后,两组患者左室收缩功能均得到显著改善,与治疗前相比具有统计学差异(P<0.05),观察组改善幅度明显优于对照组(P<0.05)。两组患者不良反应均较轻,发生率差异不具有统计学意义(P>0.05)。结论对急性心肌梗死并发心源性休克的患者给予左西孟旦治疗,临床疗效显著,可有效改善患者血压、心率以及左心室收缩功能,且无明显不良反应发生。

Objective To investigate the clinical efficacy and safety of levosimendan in treating acute myocardial infarction comPlicated by cardiogenic shock. Methods 108 cases from January 2013 to January 2015 with acute myocardial infarction comPlicated by cardio-genic shock were randomly divided into the control grouP and the observation grouP,54 cases in each grouP. Two grouPs of Patients re-ceived relevant symPtomatic treatment including norePinePhrine treatment. On the basis, the control grouP was given the micro-PumP in-travenous dobutamine,the observation grouP was given intravenous levosimendan microPumP,two grouPs of Patients were treated for two weeks. Results Blood Pressure of the two grouPs after 0. 5,1,2,24 h treatment and two weeks of treatment was higher than before treatment,heart rate was lower than before treatment,and the observed changes in blood Pressure and heart rate at various time Points in the observation grouP were significantly better in the control grouP （ P 〈 0. 05 ） . After two weeks of treatment,the left ventricular sys-tolic function in both grouPs of Patients were significantly imProved comPared with before treatment with significant difference （ P 〈0. 05 ） ,and the imProvement in the observation grouP was better than the control grouP （ P 〈 0. 05 ） . The adverse reactions were mild in both grouPs,the difference was not statistically significant （ P 〉 0. 05 ） . Conclusion For Patients with acute myocardial infarction comPli-cated by cardiogenic shock,the treatment Levosimendan has significant clinical effect,can effectively imProve blood Pressure,heart rate, and left ventricular systolic function,and no significant adverse reactions,is worth of clinical aPPlication.