左西孟旦治疗老年缺血性心肌病所致急性失代偿性心力衰竭的疗效和安全性分析

Curative effect and safety of levosimendan in elderly patients with acute decompensated heart failure due to ischemic cardiomyopathy

目的探讨左西孟旦治疗老年缺血性心肌病所致急性失代偿性心力衰竭患者的疗效和安全性。方法选择老年缺血性心肌病所致急性失代偿性心力衰竭患者60例,根据治疗方法随机分为左西孟旦组30例和常规治疗组30例。2组患者治疗前和治疗后1周分别测定血压、心率、左心室射血分数、血浆N末端钠尿肽前体和肌酐水平,并进行疗效和安全性比较。结果左西孟旦组治疗后左心室射血分数明显高于常规治疗组,血浆N末端钠尿肽前体水平明显低于常规治疗组(36.5%vs 34.0%,1872.9ng/L vs 2499.6ng/L,P<0.05)。左西孟旦组与常规治疗组治疗后血压、心率和肌酐水平比较,差异无统计学意义(P>0.05)。结论老年缺血性心肌病导致的急性失代偿性心力衰竭患者使用左西孟旦后,左心室射血分数升高,N末端钠尿肽前体水平降低,而血压、心率和肾功能并无异常,证实了左西孟旦治疗老年缺血性心肌病导致的急性失代偿性心力衰竭患者安全有效。

Objective To study the curative effect and safety of levosimendan in elderly patients with acute decompensated heart failure（HF）due to ischemic cardiomyopathy.Methods Sixty elderly patients with acute decompensated HF due to ischemic cardiomyopathy were randomly divided into levosimendan treatment group and conventional treatment group（30in each group）.Their blood pressure,heart rate,left ventricular ejection fraction（LVEF）,serum N-terminal proBNP and creatinine levels were measured before and 1 week after treatment.The curative effect and safety of levosimendan were compared in the patients.Results The LVEF was significantly higher and the serum N-terminal proBNP level was significantly lower in levosimendan treatment group than in conventional treatment group（36.5%vs 34.0%,1872.9ng/L vs 2499.6ng/L,P〈0.05）.No significant difference was found in blood pressure,heart rate and serum creatinine level between the two groups（P〉0.05）.Conclusion The LVEF is higher and the serum N-terminal proBNP level is lower in elderly patients with acute decompensated HF due to ischemic cardiomyopathy after levosimendan treatment with no change in their blood pressure,heart rate and renal function,suggesting that levosimendan is safe and effective in elderly patients with acute decompensated HF due to ischemic cardiomyopathy.