左西孟旦与多巴酚丁胺治疗充血性心力衰竭的效果及对脑钠肽、心功能的影响

Curative Effect of Levosimendan and Dobutamine in the Treatment of Congestive Heart Failure and Their Effect on Brain Natriuretic Peptide and Cardiac Function

目的探讨左西孟旦与多巴酚丁胺治疗充血性心力衰竭的效果。方法回顾性分析我院2018年1月—2019年1月收治的充血性心力衰竭患者105例的临床资料,依据治疗方式分为左西孟旦组54例和多巴酚丁胺组51例。左西孟旦组给予左西孟旦注射液,多巴酚丁胺组给予多巴酚丁胺注射液。比较2组治疗效果,治疗前后血清学指标、心功能指标、治疗后不良反应发生率,随访期间心脑血管不良事件发生情况。结果左西孟旦组治疗总有效率显著高于多巴酚丁胺组(P<0.05)。2组患者治疗后脑钠肽、尿酸显著低于治疗前,且左西孟旦组低于多巴酚丁胺组(P<0.05)。2组治疗后每搏输出量、左心室射血分数及心脏指数均高于治疗前,且左西孟旦组优于多巴酚丁胺组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。左西孟旦组患者随访期间心血管不良事件发生率显著低于多巴酚丁胺组(P<0.05)。结论左西孟旦治疗充血性心力衰竭治疗效果优于多巴酚丁胺,可显著下调脑钠肽水平,改善患者心功能。

Objective To investigate the differences in effects of levosimendan and Dobutamine in the treatment of congestive heart failure(CHF).Methods The treatment data of 105 patients with CHF from January 2018 to January 2019 in our hospital were analyzed retrospectively.According to the treatment mode,they were divided into Levosimendan group(n=54)and Dobutamine group(n=51).The Levosimendan group was given Levosimendan injection,while Dobutamine group was given Dobutamine injection.The therapeutic effect,serological index and cardiac function index before and after treatment,the incidence of adverse reactions after treatment and the incidence of adverse cardiovascular and cerebrovascular events during follow-up were compared between the two groups.Results The total effective rate of Levosimendan group was significantly higher than that of Dobutamine group(P<0.05).After treatment,the brain natriuretic peptide(BNP)and uric acid in the two groups were significantly lower than those before treatment,and the above indexes in the Levosimendan group were lower than those in the Dobutamine group(P<0.05).After treatment,stroke volume,left ventricular ejection fraction and cardiac index of the two groups were all higher than those before treatment,and the above indexes of cardiac function in the Levosimendan group were significantly better than those in the Dobutamine group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The incidence of adverse cardiovascular events was significantly lower in Levosimendan group than that in Dobutamine group(P<0.05).Conclusion Levosimendan is superior to Dobutamine in the treatment of CHF,which can significantly down-regulate BNP levels and improve cardiac function.