左西孟旦在重症患者中应用效果的研究进展

Research Progress on Application Effect of Levosimendan in Patients with Critical Illnesses

左西孟旦是一种新型钙增敏剂,主要具有正性肌力和扩张血管作用。与传统正性肌力药物相比,左西孟旦主要通过增加肌钙蛋白C对Ca^2+的敏感性而增强心肌细胞收缩力,不会增加细胞内钙负荷及心肌耗氧量,不易导致心律失常和细胞损伤,不延长舒张期时间及损伤心肌舒张功能,是一种更具优势的强心、护心药物。尽管目前左西孟旦尚未广泛用于ICU患者,但越来越多研究表明其对危重症患者心脏、肺脏、肾脏、膈肌功能等具有一定保护作用。本文主要综述了左西孟旦在心脏重症、呼吸重症、困难脱机、脓毒症、肾损伤中的应用效果,以期为重症患者提供更多的治疗思路。

Levosimendan,as a new kind of calcium sensitizers,has positive inotropic effect and angiectatic effect.Compared with traditional positive inotropic drugs,levosimendan can enhance the contractility of cardiac myocytes though increasing the sensitivity of troponin C to Ca2+,without increasing the intracellular calcium load and myocardial oxygen consumption,thus it is not easy to cause arrhythmia or cell damage,prolong the diastolic time,or damage the diastolic function of cardiac myocytes,which is more advantageous as one kind of cardiotonic and heart protecting drugs.More and more researches have shown that,levosimendan has certain protective effect on functions of heart,lung,kidney and diaphragm in critically ill patients,but it has not been widely used in patients in ICU at present.This paper mainly reviewed the application effect of levosimendan in patients with severe cardiac disease,severe respiratory disease,difficult weaning,sepsis and kidney injury,in order to provide more treatment thoughts for patients with critical illnesses.