左西孟旦联合呋塞米治疗顽固性心力衰竭的疗效分析

Clinical Analysis of Levosimendan combined with Furosemide in Treatment of Refractory Heart Failure

目的:探讨左西孟旦联合呋塞米治疗顽固性心力衰竭的疗效。方法:选取了80例顽固性心力衰竭患者,按随机数字表法分为两组对照组(39例)给予左西孟旦注射液,观察组(41例)给予左西孟旦联合呋塞米治疗后24 h,通过观察并记录治疗后的疗效,治疗前后心搏量(SV),左室射血分数(LVEF)和N末端B型利钠肽原(NT-proBNP)水平及随访3 d内不良反应情况,评价左西孟旦联合呋塞米治疗顽固性心力衰竭的疗效。结果:治疗后观察组患者心功能改善1级以上患者共37例,对照组28例,观察组有效率明显高于对照组(P<0.05),治疗前,两组SV,LVEF,NT-proBNP无统计学差异(P>0.05),治疗后,两组SV和LVEF水平均增加,且观察组高于对照组治疗后,两组NT-proBNP水平均降低,且观察组明显低于对照组(P<0.05),随访3d,两组不良反应率相比,无统计学差异(P>0.05)。结论:采用左西孟旦联合呋塞米对顽固性心力衰竭具有较好的治疗效果,能有效增强心脏收缩力,提高心输出量,减轻心力衰竭程度。

Objective：To discuss the efficacy of levosimendan combined with furosemide in treatment of refractory heart failure.Methds：80 patients with refractory heart failure were selected,they were divided into two groups randomly.The control group（39 cases）was given levosimendan,and the observation group（41 cases） was given levosimendan combined with furosemide.The clinical efficacy of levosimendan combined with furosemide in treatment of refractory heart failure was evaluated by efficacy,SV,LVEF,NT-proBNP after 24 h treatment and adverse reactions during 3 days follow-up.Results：After treatment,the heart function improved 1 grade was 37 cases in the observation group and 28 cases in the control group.The effective rate of observation group was higher than that of the control group（P〈0.05）.Before treatment,there were no statistical significance on SV,LVEF,NT-proBNP between two groups（P〉0.05）.After treatment,the SV and LVEF were increased in two groups（P〈0.05）.The SV and LVEF of observation group was higher than that of the control group（P〈0.05）.After treatment,the NT-proBNP were decreased in two groups（P〈0.05）.The NT-proBNP of observation group was lower than that of the control group（P〈0.05）.During 3 days follow-up,there were no statistical significance on adverse reactions between two groups（P〉0.05）.Conclusions：Levosimendan combined with furosemide had a good therapeutic effect on refractory heart failure.It can enhance heart contractility,improve cardiac output and reduce the degree of heart failure.