左西孟旦治疗老年急性心肌梗死合并心力衰竭临床观察

A clinic research of levosimendan in treatment of elderly acute myocardial infarction complicating heart failure

目的评价左西孟旦治疗老年急性心肌梗死合并心力衰竭疗效和安全性。方法选取2016年1月至2016年10月住院于徐州医科大学附属医院诊断为老年急性心肌梗死合并心力衰竭(Killip分级Ⅱ~Ⅲ级)患者60例,随机分为治疗组36例和对照组24例。对照组给予抗凝、抗血小板聚集等常规治疗,治疗组在对照组基础上静脉加用左西孟旦治疗。比较2组患者治疗前及治疗7天后血浆N末端B型利钠肽原(NT-pro BNP)、高敏C-反应蛋白(hs-CRP)水平和左室射血分数(LVEF)值,并统计治疗期间的不良反应情况。结果治疗组1例因出现持续性低血压退出本研究。治疗7天后,治疗组与对照组组间比较血浆NT-pro BNP、hs-CRP水平下降更显著,LVEF值提高更明显,均有统计学意义(P<0.05)。结论左西孟旦治疗老年急性心肌梗死合并心力衰竭疗效明显,不良反应少,安全性高。

Objective To evaluate the clinical effect and safety of levosimendan on the treatnmnt of elderly acute myocardial infarction complicating heart failure. Methods 50 elderly patients with acute myocardial infarction complicating heart failure were chosen, which were randomly divided into treatment group （ n = 35 ） and control group （ n = 24 ）. The control group was given anticoagulation and antiplatelet aggregation and other conventional treatment. The treatment group was treated with intravenous levosimendan on the basis of the control group therapy. The plasma NT-proBNP, hs-CRP levels and LVEF level were compared before and after 7 days of treatment in patients, and statistical the adverse reactions in the treatment period. Results In the treatment group, one patient was rejected because of persistent hypotension. After 7 days of the treat- ment,compared with the control group,the plasma NT-proBNP, hs-CRP levels of the treatment group de- creased more lower, and LVEF level of the treatment group elevated higher. And the statistical differences were significant （ P 〈 0.05 ）. Conclusion The clinical effect using levosimendan in treatment of elderly acute myocardial infarction complicating heart failure is obvious. The adverse reaction is less and safety is high.