左西孟旦与多巴酚丁胺治疗扩张型心肌病并顽固性终末期心衰的对比分析

Comparative analysis of levosimendan and dobutamine in treatment of patients with dilated cardiomyopathy and refractory end-stage heart failure

目的对比左西孟旦与多巴酚丁胺治疗扩张型心肌病并顽固性终末期心衰的疗效。方法将2016年2月~2017年2月我院90例扩张型心肌病并顽固性终末期心衰患者采用数字表法分为两组,对照组予常规抗心衰和多巴酚丁胺治疗,观察组予常规抗心衰和左西孟旦治疗,比较两组的临床治疗效果及症状改善时间、心衰纠正时间;两组患者干预前后左室射血分数、左室舒张末期内径、脑钠肽、心脏指数、药物副作用发生率。结果观察组扩张型心肌病并顽固性终末期心衰治疗效果高于对照组(P<0.05);观察组症状改善时间、心衰纠正时间短于对照组(P<0.05);干预前两组左室射血分数、左室舒张末期内径、脑钠肽、心脏指数相近(P>0.05);干预后观察组左室射血分数、左室舒张末期内径、脑钠肽、心脏指数优于对照组(P<0.05)。两组药物副作用发生率比较,无显著差异(P>0.05)。结论左西孟旦与多巴酚丁胺治疗扩张型心肌病并顽固性终末期心衰的对比,左西孟旦效果更好,可更快改善心功能、纠正心衰,且药物安全性较高,值得推广。

Objective To investigate the efficacy of levosimendan and dobutamine in the treatment of dilated cardiomyopathy combined with refractory end-stage heart failure. Methods A total of 90 patients with dilated cardiomyopathy and refractory end-stage heart failure in our hospital from February 2016 to February 2017 were enrolled and grouped according to digital table method. The control group received conventional anti-heart failure treatment and dobutamine treatment. The observation group received conventional anti-heart failure treatment and levosimendan treatment. The treatment effects of dilated cardiomyopathy and refractory end-stage heart failure, the symptom improvement time, heart failure correction time, left ventricular ejection fraction, left ventricular end diastolic diameter, brain natriuretic peptide,cardiac index before and after intervention and drug side effects rate between two groups were compared. Results The treatment effect of dilated cardiomyopathy and refractory end-stage heart failure was higher in the observation group than that in the control group（P〈0.05）. The improvement time of symptoms and the correction time of heart failure in the observation group were shorter than those in the control group（P〈0.05）. The ventricular ejection fraction, left ventricular end diastolic diameter, brain natriuretic peptide, and cardiac index in two groups were similar（P〈0.05）. After the intervention, the left ventricular ejection fraction, left ventricular end diastolic diameter, brain natriuretic peptide,and cardiac index in the observation group were superior to those of the control group（P〈0.05）. There was no significant difference in drug side effects between the two groups, both of which were mild（P〈0.05）. Conclusion Levosimendan has a better effect in patients with dilated cardiomyopathy and refractory end-stage heart failure than dobutamine does. Levosimendan can improve heart function and correct heart failure more quickly, with high drug safety,and is worth promoting.