左西孟旦治疗老年慢性心力衰竭患者临床疗效及对患者心功能、肾素-血管紧张素-醛固酮系统的影响

Curative effect of levosimendan in treatment of elderly patients with chronic heart failure and its influence on cardiac function and renin-angiotensin-aldosterone system

目的:探讨左西孟旦(Levo)对老年慢性心力衰竭患者(CHF)的心功能及肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法:选取98例老年CHF患者,利用简单随机抽样法分为观察组(n=49例)和对照组(n=49例),对照组采用常规治疗,观察组在对照组基础上加用Levo治疗,比较两组治疗效果以及治疗前后超声心动图参数、心肌损伤因子以及RAAS指标的变化。结果:观察组治疗总有效率为95.92%明显高于对照组的81.63%(P<0.05);观察组治疗后超声心动图参数每搏输出量(SV)、左室射血分数(LVEF)大于对照组(P<0.05),左心室舒张期末内径(LVEDD)、左室收缩末期内径(LVESD)和心肌损伤因子血清肌钙蛋白I(cTnI)、心型脂肪酸结合蛋白(H-FABP)、氨末端脑利钠肽前体(NT-proBNP)以及RAAS指标血清肾素(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)小于对照组(P<0.05)。结论:Levo应用于老年CHF临床效果良好,可有效改善患者心功能以及RAAS指标。

Objective:To explore the effect of levosimendan(Levo)on cardiac function and renin-angiotensin-aldosterone system(RAAS)in elderly patients with chronic heart failure(CHF).Methods:A total of 98 elderly CHF patients were selected.According to simple random sampling method,they were divided into observation group(n=49)and control group(n=49).The control group was given routine treatment,while observation group was additionally given Levo.The curative effect,changes of echocardiogram(ECG)parameters,myocardial injury factors and RAAS indexes before and after treatment were compared between the two groups.Results:The total effective rate of observation group was significantly higher than that of control group(95.92%vs.81.63%,P<0.05).After treatment,stroke volume(SV)and left ventricular ejection fraction(LVEF)of observation group were greater than those of control group(P<0.05),while left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),myocardial injury factors[serum cardiac troponin I(cTnI),heart-type fatty acid binding protein(H-FABP),N-terminal pro brain natriuretic peptide(NT-proBNP)]and RAAS indexes[plasma renin activity(PRA),angiotensinⅡ(AngⅡ),aldosterone(ALD)]were lower than those of control group(P<0.05).Conclusion:The clinical effect of Levo is good in the treatment of the elderly with CHF,which can effectively improve their cardiac function and RAAS indexes.