左西孟旦与米力农治疗失代偿性心力衰竭的近期疗效及预后比较

Comparison of short-term therapeutic effect and prognosis between levosimendan and milrinone on patients with decompensated heart failure

目的:观察左西孟旦与米力农治疗对失代偿性心力衰竭患者的近期疗效及预后比较。方法:选择在我院治疗的120例失代偿性心力衰竭患者,分为左西孟旦组(常规抗心衰治疗基础上加用左西孟旦)和米力农组(常规抗心衰治疗基础上加用米力农),各60例。持续治疗一周,比较两组治疗前后脑钠肽(BNP)、左室射血分数(LVEF)和6min步行距离(6MWD)的变化。结果:与治疗前比较,治疗一周后两组患者的BNP水平均明显下降,LVEF明显提高(P均=0.001);且与米力农组相比,左西孟旦组治疗一周后BNP[(224.45±29.45)pg/ml比(197.41±27.65)pg/ml]水平明显降低,LVEF[(37.72±2.03)%比(44.33±1.94)%]明显提高(P均=0.001)。与治疗前比较,治疗3个月后两组6MWD明显增加(P=0.001),且左西孟旦组6MWD[(441.76±75.45)m]明显大于米力农组的[(409.63±73.56)m],P=0.02。结论:失代偿性心力衰竭患者在常规抗心衰药物治疗上联用左西孟旦的近期疗效及预后显著优于联用米力农的。

Objective:To observe short-term therapeutic effect and prognosis of levosimendan or milrinone on patients with decompensated heart failure(DHF).Methods:A total of 120 DHF patients treated in our hospital were equally divided into levosimendan group(received levosimendan based on routine anti-HF treatment)and milrinone group(received milrinone based on routine anti-HF treatment),both groups were treated for one week continuously.Level of brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF)and 6min walking distance(6MWD)were compared between two groups before and after treatment.Results:Compared with before treatment,on one week after treatment,there was significant reduction in BNP level and significant rise in LVEF in two groups,P=0.001 all;compared with milrinone group after one-week treatment,there was significant reduction in BNP level[(224.45±29.45)pg/ml vs.(197.41±27.65)pg/ml]and significant rise in LVEF[(37.72±2.03)%vs.(44.33±1.94)%]in levosimendan group,P=0.001 both.Compared with before treatment after three-month treatment,there was significant rise in 6MWD in two groups(P=0.001),and 6MWD of levosimendan group was significantly longer than that of milrinone group[(441.76±75.45)m vs.(409.63±73.56)m],P=0.02.Conclusion:Short-term therapeutic effect and prognosis of routine anti-HF medication combined levosimendan are significantly better than those of combined milrinone treatment in DHF patients.