左西孟旦对扩张型心肌病慢性心力衰竭患者心功能的影响及疗效观察

Effect of levosimendan on cardiac function and curative effect in patients with dilated cardiomyopathy and chronic heart failure

目的探讨左西孟旦对扩张型心肌病慢性心力衰竭患者心功能的影响及治疗效果。方法选取2015年6月至2016年12月福建省宁德市医院收治的扩张型心肌病心力衰竭患者60例,按照入院顺序编号,根据随机数字表法随机分为观察组(30例)和对照组(30例)。对照组患者采用常规治疗方式,观察组患者在对照组基础上给予左西孟旦治疗;治疗一个疗程后,对比两组患者心功能[脑利钠肽(NT-pro BNP)、每搏输出量(SV)、心肌做功指数(MPI)及射血分数(LVEF)]变化、临床疗效(以治疗前后NYHA分级改善情况及症状改善情况进行评价)及不良反应发生情况。结果观察组患者治疗总有效率高于对照组,差异有统计学意义(P <0. 05)。治疗后,两组患者NT-pro BNP和MPI均较治疗前下降,SV和LVEF均上升,差异均有统计学意义(P均<0. 05);观察组钾、钠、钙、氯化物、肌酐、尿素氮、收缩压、舒张压、心率与对照组比较,差异无统计学意义(均P> 0. 05)。治疗期间两组患者不良反应发生率差异无统计学意义(P> 0. 05)。结论左西孟旦能有效改善扩张型心肌病慢性心力衰竭患者心脏功能,且疗效显著,无严重不良反应发生。

Objective To explore the effect of levosimendan on cardiac function in patients with chronic heart failure with dilated cardiomyopathy and its therapeutic effect. Methods Sixty patients with dilated cardiomyopathy and heart failure received treatment at Ningde City Hospital of Fujian Province from June 2015 to Dec 2016 were selected. Patients were numbered with hospital admission order and randomly divided into observation group （30 cases） and control group （30 cases） according to the random number table method. The control group was treated with conventional treatment, and the observation group with levosimontan on the basis of control group. After a course of treatment, the cardiac function （N terminal-pro brain natriuretic peptide（NT-pro BNP）, stroke volume（SV）, myocardial activity index （MPI） and blood ejection fraction （LVEF））, clinical efficacy （evaluation of NYHA grading improvement and symptom improvement before and after treatment） and adverse reactions were compared between the two groups. Results The total effective rate in observation group was significantly better than that in control group （ P 〈0.05）. After treatment, the levels of NT-pro BNP and MPI in the two groups decreased, while SV and LVEF increased. The difference all had statistical significance （ P 〈0.05）. There was no significant difference in potassium, sodium, calcium, chloride, creatinine, urea nitrogen, systolic blood pressure, diastolic blood pressure, heart rate between observation group and control group （ P 〉0.05）. There was no significant difference in the incidence of adverse reactions between the two groups during treatment （ P 〉0.05）. Conclusion The levosimendan can significantly reduce levels of NT-pro BNP and MPI, increase levels of SV and LVEF in patients with chronic heart failure with dilated cardiomyopathy, and effectively improve heart function. The effect is significant without serious adverse reactions.