左西孟旦对急性心肌梗死后左心衰竭患者心功能、血压及心率的影响

Effects of levosimendan on cardiac function,blood pressure and heart rate of patients with left ventricular failure after acute myocardial infarction

目的探讨新型钙离子增敏剂左西孟旦治疗急性心肌梗死后左心衰竭患者心功能、血压及心率的变化情况。方法随机选择62例诊断明确的急性心肌梗死早期合并左心力衰竭并需要正性肌力药物治疗的患者,随机分为左西孟旦治疗组和对照组。左西孟旦治疗组给予静脉注射左西孟旦药物治疗;对照组应用多巴酚丁胺药物治疗。监测两组患者治疗前后血压、心率、血生化、肝肾功等指标;观察1周内两组患者主要不良心脏事件的发生情况;检测两组患者血液、肝肾功能及血电解质,并记录所用药物相关不良事件。结果左西孟旦治疗组患者治疗前后心功能改善率优于对照组(P<0.05);观察周期内左西孟旦治疗组发生的主要不良心脏事件少于对照组(P<0.05);左西孟旦治疗组患者经治疗后血压轻微降低(P<0.05)。结论左西孟旦可以明显改善急性心肌梗死合并左心衰竭患者的心功能,使收缩压轻度下降;与对照组相比,不增加心律失常发生率;在急性心肌梗死早期合并左心衰竭的患者中,应用左西孟旦安全、有效。

Objective To observe the changes of cardiac function, blood pressure and heart rate of patients with left ventricular failure complicating acute myocardial infarction after the treatment with levosimendan. Methods Sixty-two patients with left ventricular failure after acute myocardial infarction and with need for inotropic agents were included and were randomly divided into the levosimendan group and the control group. The levosimendan group received intravenous levosimendan while dobutamine was given in the control group. Blood pressure,heart rate and other test indicators were monitored before and after the treatment. We observed the major adverse cardiac events of both groups within 1 week. We tested the blood,hepatorenal function, and blood electrolytes, and recorded adverse events related to drugs used. Results After treatment, the improvement rate of cardiac function in the levosimendan group was significantly higher than that in the control group （P〈0.05）. Major adverse cardiac events of the levosimendan group was less than that in the control group during the observation period （P〈0.05）. Blood pressure decreased slightly in the levosimendan group after treatment compared with baseline （ P〈0.05 ）. Conclusion Levosimendan can significantly improve cardiac function in patients with left ventricular failure after acute myocardial infarction, and can make systole blood pressure decrease slightly. Compared with the control group, levosimendan does not increase arrhythmias. Levosimendan is effective and safe for patients with with left ventricular failure after early acute myocardial infarction.