联合用药治疗急性一氧化碳中毒合并失代偿性心力衰竭102例

Clinical study of Levosimendan combined with nitroglycerin in the treatment of acute carbon monoxide poisoning with decompensatory heart failure

目的观察左西孟旦联合硝酸甘油治疗急性一氧化碳中毒合并失代偿性心力衰竭临床疗效。方法选取急性一氧化碳中毒合并失代偿性心力衰竭患者102例,随机分为治疗组和对照组各51例,对照组给予常规治疗并加用硝酸甘油,治疗组在对照组治疗的基础上加用左西孟旦。比较两组患者治疗前后血清氨基末端脑钠肽(NT-pro BNP)、胱抑C(Cys C)及每搏输出量(SV)、心脏指数(CI)、左心室射血分数(LVEF)及迟发性脑病(DEACMP)发生率;应用SPSS 22.0软件,所获数据采用2检验和t检验。结果同组治疗前后Cys C、NT-pro BNP比较,P<0.05;两组治疗前Cys C、NT-pro BNP比较,P>0.05;两组治疗后Cys C、NT-pro BNP比较,P<0.05。两组治疗前,SV、CI、LVEF比较,P>0.05;两组治疗后SV、CI、LVEF比较,P<0.05;同组治疗前后比较,P<0.05。两组DEACMP发生率比较,P<0.05。结论左西孟旦联合硝酸甘油治疗急性一氧化碳中毒合并失代偿性心力衰竭疗效显著,值得推广应用。

Objective To investigate the clinical efficacy of levosimendan combined with nitroglycerin in the treatment of acute carbon monoxide poisoning and decompensated heart failure. Methods One hundred and twenty patients with acute carbon monoxide poisoning and decompensated heart failure were randomly divided into treatment group and control group with 51 patients in each group. The control group was given conventional treatment plus nitroglycerin, and the treatment group was added to the treatment in the control group. Left Ximengdan. To compare serum NT-proBNP, CysC and stroke volume （SV）, cardiac index （CI）, left ventricular ejection fraction （LVEF）, and delay in both groups before and after treatment. The incidence of encephalopathy （DEACMP）; data were statistically processed using SPSS 22.0 software,the data obtained were analyzed using Z2 test and t test. Results Compared with the same group before and after treatment, CysC, NT-proBNP, P〈0.05; before treatment, CysC, NT-proBNP, P〉0.05; after treatment, CysC, NT-proBNP, P〈0.05. Before treatment, SV, CI, and LVEF were compared, P〉0.05; SV, CI, and LVEF were compared between the two groups after treatment, P〈0.05; P〈0.05 compared with before and after treatment in the same group. The incidence of DEACMP in the two groups was compared, P〈0.05. Conclusion The combination of levosimendan and nitroglycerin is effective in the treatment of acute carbon monoxide poisoning and decompensated heart failure. It is worthy of popularization and application.