左西孟旦对脓毒症诱导的心肌抑制患者心功能的影响研究

Effects of levosimendan on cardiac function of patients with sepsis-induced myocardial dysfunction

目的探讨左西孟旦对脓毒症诱导的心肌抑制(SIMD)患者心功能的影响。方法47例脓毒症休克存在SIMD患者,采用随机数字表法将患者分为观察组(23例)和对照组(24例)。对照组采用常规治疗,观察组在常规治疗基础上加用左西孟旦治疗。比较两组患者治疗前及治疗72 h后左室射血分数(LVEF)、左室收缩末期容积指数(LVESI)、左室舒张末期容积指数(LVEDI)、心肌肌钙蛋白I(cTnI)、脑钠肽(BNP)水平。结果治疗前,两组LVEF、LVESI、LVEDI水平比较差异无统计学意义(P>0.05);治疗72 h后,对照组LVEF、LVESI、LVEDI与本组治疗前比较差异无统计学意义(P>0.05);观察组LVEF、LVESI、LVEDI均优于本组治疗前,且观察组LVEF(46.6±6.5)%、LVESI(35.5±14.2)ml/m^2、LVEDI(67.5±12.7)ml/m^2优于对照组的(38.3±5.3)%、(46.2±13.7)ml/m^2、(76.6±11.4)ml/m^2,差异有统计学意义(P<0.05)。治疗前,两组cTnI、BNP水平比较差异无统计学意义(P>0.05);治疗72 h后,两组cTnI、BNP水平均较本组治疗前降低,且观察组降低程度优于对照组,差异具有统计学意义(P<0.05)。结论左西孟旦能够改善SIMD患者的心功能状态,并达到保护心肌细胞、减轻心肌损伤的目的,具有较高临床推广价值。

Objective To discuss the effect of levosimendan on cardiac function of patients with sepsisinduced myocardial dysfunction(SIMD).Methods A total of 47 patients with sepsis-induced myocardial dysfunction were divided into observation group(23 cases)and control group(24 cases).The control group received conventional therapy,and the observation group received levosimendan on the basis of conventional therapy.The left ventricular ejection fraction(LVEF),left ventricular end-systolic volume index(LVESI),left ventricular enddiastolic volume index(LVEDI),and cardiac troponin I(cTnI)and brain natriuretic peptide(BNP)levels before treatment and 72 h after treatment were compared between the two groups.Results Before treatment,there was no statistically significant difference in LVEF,LVESI and LVEDI between the two groups(P>0.05).At 72 h after treatment,LVEF,LVESI and LVEDI of the control group had statistically significant difference compared with those before treatment(P>0.05);LVEF,LVESI and LVEDI of the observation group were better than those before treatment,and LVEF(46.6±6.5)%,LVESI(35.5±14.2)ml/m^2,LVEDI(67.5±12.7)ml/m^2 of the observation group were better than(38.3±5.3)%,(46.2±13.7)ml/m^2,(76.6±11.4)ml/m^2 of the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in cTnI and BNP between the two groups(P>0.05).At 72 h after treatment,cTnI and BNP of the two groups were lower than those before treatment,and the reduction in the observation group was better than that in the control group.The difference was statistically significant(P<0.05).Conclusion Levosimendan can improve the cardiac function of SIMD patients,thus protecting myocardial cells and reducing myocardial damage.It has high clinical promotion value.