左西孟旦治疗急性心肌梗死并发心力衰竭的疗效及安全性分析

Efficacy and safety of levosimendan in patients with acute myocardial infarction complicated with heart failure

目的评定左西孟旦(levosimendan)治疗急性心肌梗死并发心力衰竭患者的疗效及安全性。方法将68例急性心肌梗死并发心力衰竭的患者随机分为左西孟旦组(31例)和米力农组(37例)。两组患者均接受常规治疗,冠状动脉造影确定心肌梗死存在,超声心动图和血流动力学检测明确心力衰竭存在,两组分别用左西孟旦及米力农补充治疗。持续治疗7 d,分别行超声心动图、漂浮导管检查,1、3、7 d检测氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)浓度,观察并比较两组临床表现及心功能分级的变化。结果 7 d时左西孟旦组超声心动图改变、血流动力学监测改善效果均明显高于米力农组,差异有统计学意义(P<0.05);左西孟旦组心功能分级及临床表现改善较米力农组提前,差异有统计学意义(P<0.05)。结论左西孟旦可改善心肌梗死并发心力衰竭患者心功能,在一定程度上有利于心肌梗死合并心力衰竭患者心功能的恢复。

Objectives To evaluate the efficacy and safety of levosimendan in patients with acute myocardial infarc?tion complicated with heart failure.Methods Totally68patients with acute myocardial infarction complicated with heart failure were randomly divided into levosimendan group(31cases)and milrinone group(37cases).Patients in the two groups were treated for a conventional treatment.Coronary angiography was used to determine myocardial infarc?tion.Echocardiography and hemodynamic measurements were used to detect heart failure.Levosimendan group received levosimendan and milrinone group received milrinone as supplementation.After7days of continuous treatment,pa?tients were measured by echocardiography and floating catheter examination respectively.Concentrations of N-terminal pro-brain natriuretic peptide(NT-proBNP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)were detected at1,3,7d.Changes of clinical symptoms and cardiac function classification of the patients were observed and compared.Results After treating for7days,improvements of echocardiography and hemodynamic measurements in levosimendan group were significantly better than those in milrinone group(P<0.05);improvements of cardiac func?tion classification and clinical manifestations of levosimendan group were significantly higher than those of milrinone group(P<0.05).Conclusion Levosimendan can improve cardiac function in patients with myocardial infarction complicated with heart failure,to a certain extent,it is conducive to the recovery of them.