参麦注射液联合左西孟旦治疗扩张型心肌病难治性心力衰竭的临床研究

Clinical study on Shenmai Injection combined with levosimendan in treatment of dilated cardiomyopathy refractory heart failure

目的观察参麦注射液联合左西孟旦治疗扩张型心肌病难治性心力衰竭的临床疗效。方法选取2013年7月—2015年4月昌江黎族自治县中西医结合医院收治的扩张型心肌病难治性心力衰竭患者80例,随机分为对照组和治疗组,每组各40例。对照组给予左西孟旦注射液,初始负荷剂量12μg/kg,静脉注射时间>10 min,之后用微量泵以0.075μg/(kg·min)的剂量持续性的泵入24 h;治疗组在对照组的基础上静脉滴注参麦注射液,60 mL溶解于5%葡萄糖溶液150 mL中,1次/d,连续治疗2周。观察两组的临床疗效,同时比较6 min步行实验(6 MWT)、脑钠肽(BNP)及心脏功能的变化情况。结果治疗后,对照组和治疗组的总有效率分别为72.50%、92.50%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者6 MWT距离明显增加,而BNP水平显著下降,同组治疗前后差异有统计学意义(P<0.05);且这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的心排血量(CO)、心脏排血指数(CI)和射血分数(EF)水平均显著升高,同组治疗前后差异有统计学意义(P<0.05);且这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论参麦注射液联合左西孟旦治疗扩张型心肌病难治性心力衰竭具有较好的临床疗效,能够显著改心脏功能,提高运动能力,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Shenmai Injection combined with levosimendan in treatment of dilated cardiomyopathy refractory heart failure. Methods Patients（80 cases） with dilated cardiomyopathy refractory heart failure in Hospital of Integrated Chinese and Western Medicine of Changjiang Li Autonomous County from July 2013 to April 2015 were randomly divided into the control and treatment groups, and each group had 40 cases. Patients in the control group were given Levosimendan Injection, initial loading dose was 12 μg/kg, time of intravenous injection was more than 10 min, then 0.075 μg/（kg·min） was continually pumping for 24 h by micro pump. Patients in the treatment group were iv administered with Shenmai Injection on the basis of the control group, 60 mL added into 5% glucose solution 150 mL, once daily, and treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and 6 MWT, BNP, and cardiac function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.50% and 92.50%, respectively, and there was difference between two groups（P〈 0.05）. After treatment, 6 MWT distances in two groups were obviously increased, but BNP levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈 0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈 0.05）. After treatment, CO, CI, and EF in two groups were significantly increased, and the difference was statistically significant in the same group（P〈 0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈 0.05）. Conclusion Shenmai Injection combined with levosimendan has clinical curative effect in treatment of dilated cardiomyopathy refractory heart failure, and can significantly improve cardiac function, enhance athletic ability, which has a certain clinical application value.