左西孟旦治疗急性心力衰竭患者的临床效果及其对血清心肌损伤标志物水平的影响

Clinical effect of levosimendan in the treatment of patients with acute heart failure and its influence on serum levels of myocardial injury markers

目的观察左西孟旦治疗冠心病(CHD)并发急性心力衰竭(AHF)患者的临床效果及其对患者血清心肌损伤标志物水平的影响。方法选取2018年6月至2019年7月我院收治的无心肌梗死的CHD合并AHF患者60例为研究对象,采用随机数字法分为研究组与对照组,每组30例。对照组患者接受常规治疗,研究组患者在对照组治疗的基础之上加用左西孟旦治疗。比较两组患者治疗前、治疗7 d后的左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)以及血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、肌钙蛋白(cTnl)、N末端B型利钠肽原(NT-ProBNP)水平;比较两组患者治疗期间的不良反应发生情况。结果治疗7 d后,两组患者的LVEF水平明显升高,研究组的水平明显高于对照组;两组患者的LVESD、LVEDD、hs-CRP、TNF-α、cTnl、NT-ProBNP水平明显降低,研究组的水平明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论在常规药物治疗的基础上加用左西孟旦治疗,可明显改善CHD合并AHF患者的心功能,降低患者的血清炎症因子水平,减轻患者的心肌损伤,治疗安全性良好。

Objective To observe the clinical effect of levosimendan in the treatment of patients with coronary heart aisease(CHD)complicated with acute heart failure(AHF)and its influence on serum levels of myocardial injury markers.Methods A total of 60 patients with non-myocardial infarction CHD complicated with AHF admitted to our hospital from June 2018 to July 2019 were selected as the research objects,and according to the random number method,the patients were divided into study group and control group,with 30 cases in each group.The control group was received conventional treatment,based on which the study group was additionally given levosimendan.The left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),cardiac troponin(cTnl),N-terminal pro-B-type natriuretic peptide(NT-ProBNP)levels before and 7 days after treatment between the two groups were compared.The occurrence of adverse reactions during the treatment of the two groups was also compared.Results After 7 days of treatment,the LVEF level of the two groups significantly increased,and the level of the study group was significantly higher than that of the control group;meanwhile,the levels of LVESD,LVEDD,hs-CRP,TNF-α,cTnl,and NT-ProBNP significantly decreased in the two groups,and the study group yielded lower levels of the above-mentioned indicator as compared with the control group,with statistically significant differences(P<0.05).During the treatment,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Additionally administration of levosimendan based on the conventional treatment can effectively improve cardiac function of patients with CHD complicated with AHF,decrease levels of serum inflammatory indicators,and alleviate myocardial injury in patients,with a preferable safety.