左西孟旦治疗慢性心力衰竭的疗效观察

Efficacy of levosimendan on chronic heart failure

目的观察左西孟旦治疗慢性心力衰竭(CHF)的疗效。方法选取2014年9月~2015年9月在青岛阜外心血管病医院心脏中心住院治疗的CHF患者64例,其中男性35例,女性29例,年龄39~79(58.76±12.89)岁,将所有患者随机分为观察组与对照组,每组各32例。对照组给予传统抗心力衰竭治疗,观察组在对照组基础上加用左西孟旦注射液治疗。于治疗前后检测左室射血分数(LVEF)、N末端脑钠肽前体(NT-pro BNP)和评价治疗的疗效。结果对照组显效11例(34.4%),有效11例(34.4%),总有效率68.8%;观察组显效12例(37.6%),有效15例(46.8%),总有效率84.4%,观察组总有效率高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,观察组和对照组LVEF升高,NT-pro BNP降低,差异有统计学意义(P均<0.05)。与对照组治疗后比较,观察组LVEF[(36.31±7.39)%vs.(39.87±6.74)%]升高,NT-pro BNP[(5904.23±1027.35)pg/ml vs.(5418.06±1008.40)pg/ml]降低,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论加用左西孟旦治疗较传统治疗有效,能显著改善CHF患者的心功能和心肌损伤。

Objective To observe the curative effect of levosimendan on chronic heart failure （CHF）. Methods CHF patients （n=64, male 35, female 29, aged from 39 to 79 and average age=58.76 ±12.89） were chosen from Sept. 2014 to Sept. 2015, and then randomly divided into observation group and controi group （each n=32）. The control group was given traditional anti-CHF therapy, and observation group was additionally given levosimendan injection. The changes of left ventricular ejection fraction （LVEF） and N-terminal pro brain natriuretic peptide （NT-proBNP） were detected before and after treatment, and curative effect of levosimendan was reviewed. Results There were 11 eases （34.4%） with significant curative effect and 11 （34.4%） with curative effect, and the total effective rate was 68.8% in control group. There were 12 cases （37.6%） with significant curative effect and 15 （46.8%） with curative eft^ct, and the total effective rate was 84.4% in observation group. The difference was significant statistically between 2 groups （P〈0.05）. The level of LVEF increased and level of NT-proBNP decreased in 2 groups after treatment （all P〈0.05）. Compared with control group, LVEF [（36.31 ± 7.39）% vs. （39.87 ± 6.74）%] increased and NT-proBNP [（5904.23 ± 1027.35） pg/ml vs. （5418.06± 1008.40） pg/ml] decreased in observation group after treatment （all P〈0.05）. The difference in incidence of adverse reactions had no statistical significance between 2 groups （P〉0.05）. Conclusion Levosimendan combining traditional therapy has higher curative effect than only traditional therapy, which can significantly improve heart function and relieve myocardial injury in CHF patients.