左西孟旦联合小剂量多巴胺治疗难治性心力衰竭的疗效观察

Clinical Study of Levosimendan Combined with Low-dose of Dopamine in the Treatment of Refractory Heart Failure

目的:探讨左西孟旦联合小剂量多巴胺治疗难治性心力衰竭的疗效观察。方法:回顾性分析80例难治性心力衰竭患者的临床资料,采用小剂量2~3μg·(min·kg)-1多巴胺进行治疗为对照组,多巴胺联合左西孟旦进行治疗为观察组,比较2组患者临床疗效、治疗前后TNF-α、CRP、IL-6水平、心功能变化及N末端脑钠肽(NT-proBNP)情况、再住院率和死亡率。结果:观察组患者总有效率90.00%高于对照组的67.50%(P<0.05);治疗后3、6个月2组比较,观察组CRP [(7.36±0.45)vs(8.74±1.05)、(5.68±0.64)vs(8.66±1.17) mg·L^-1],TNF-α[(142.63±20.41)vs(160.33±19.08)、(130.44±18.73)vs(159.72±19.65)μg·L^-1],IL-6[(24.26±5.17)vs(27.73±6.84)、(18.72±5.01)vs(26.88±6.45)μg·L^-1]均优于对照组(P<0.05);观察组LVS[(42.58±4.19)vs(50.99±4.57)、(40.78±4.07)vs(49.43±4.62) mm],LVEF[(47.85±5.39)%vs(45.74±4.77)%、(49.97±5.73)%vs(46.26±5.64)%]及NT-proBNP[(480.44±20.11)vs(511.37±18.48)、(419.22±11.68)vs(509.66±13.48) pg·L^-1]指标均优于对照组(P<0.05)。2组再次住院率和死亡率比较差异无统计学意义(P>0.05)。结论:左西孟旦联合小剂量多巴胺药物治疗难治性心力衰竭的临床疗效明显优于单纯多巴胺用药,可改善患者炎症水平,提高患者心功能。

Objective:To investigate the efficacy of levosimendan combined with low-dose dopamine in the treatment of refractory heart failure.Methods:The clinical data of 80 patients with refractory heart failure were retrospectively analyzed.The group treated with low-dose 2~3μg·(min·kg)-1 dopamine was the control group,and the group treated with dopamine combined with levosimendan was the observation group.The clinical efficacy,TNF-α,CRP,IL-6 levels,cardiac function changes,N-terminal brain natriuretic peptide(NT-proBNP)status,rehospitalization rate and mortality of the two groups of patients were compared.Results:The total clinical effective rate of the observation group(90.00%)was higher than that of the control group(67.50%)(P<0.05).Compared with the control group,CRP in the observation group 3 months after treatment and 6 months after treatment[(7.36±0.45)vs(8.74±1.05)mg·L^-1,(5.68±0.64)vs(8.66±1.17)mg·L-1],TNF-α[(142.63±20.41)vs(160.33±19.08)μg·L^-1,(130.44±18.73)vs(159.72±19.65)μg·L^-1],IL-6[(24.26±5.17)vs(27.73±6.84)μg·L^-1,(18.72±5.01)vs(26.88±6.45)μg·L^-1]were better than the control group(P<0.05);Compared with the control group,LVS in the observation group 3 months after treatment and 6 months after treatment[(42.58±4.19)vs(50.99±4.57)mm,(40.78±4.07)vs(49.43±4.62)mm],LVEF[(47.85±5.39)vs(45.74±4.77),(49.97±5.73)vs(46.26±5.64)]and NT-proBNP[(480.44±20.11)vs(511.37±18.48)pg·L^-1,(419.22±11.68)vs(509.66±13.48)pg·L-1]indexes were better than the control group(P<0.05).There was no statistically significant difference in rehospitalization rate and mortality rate between the 2 groups(P>0.05).Conclusion:The clinical efficacy of levosimendan combined with low-dose dopamine in the treatment of refractory heart failure is significantly better than that of dopamine alone,which can improve the level of inflammation and patients’cardiac function.