左西孟旦治疗心肌梗死伴心肾综合征的临床研究

Clinical Study of Levosimendan in the Treatment of Myocardial Infarction with Cardiorenal Syndrome

目的:探讨左西孟旦在治疗心肌梗死合并心肾综合征疾病的疗效及安全性。方法:选取2015年1月至2021年6月九江市第一人民医院患心肌梗死合并心肾综合征病例60例,按随机分配的方法分成以下2组,常规治疗组(n=30):抗血小板聚集、抗凝、扩张冠状动脉改善心肌供血、降脂调脂稳定斑块、抑制心脏重构、利尿、扩张外周血管、强心等治疗。左西孟旦治疗组(n=30):常规治疗基础上予左西孟旦强心治疗。比较两组治疗效果、心功能、肾功能及不良反应。结果:与常规治疗组比较,左西孟旦治疗组治疗效果更优(P<0.05);左西孟旦治疗组左室射血分数(LVEF)、心房收缩期A峰速度比值(E/A)高于常规治疗组(P<0.05);左西孟旦治疗组左室舒张末径(LVDEd)、左房内径(LAd)低于常规治疗组(P<0.05);左西孟旦治疗组6 min步行距离大于常规治疗组(P<0.05);与常规治疗组比较,左西孟旦治疗组不良反应发生率更低(P<0.05)。结论:左西孟旦治疗心肌梗死合并心肾综合征安全且疗效显著,能明显改善患者的心功能及肾功能。

Objective:To investigate the efficacy and safety of levosimendan in the treatment of myocardial infarction complicated with cardiorenal syndrome.Methods:60 cases of myocardsal infarction complicated with cardiorenal syndrome in Jiujiang First People's Hospital from January 2015 to June 2021 were selecte,by random allocation method was divided into the following two groups.The conventional treatment group(n=30):antiplatelet aggregation,anticoagulation,expanding coronary artery to improve myocardial blood supply,stable lipid-lowering lipid plaques,inhibition of cardiac remodeling peripheral vascular and strong heart,diuresis,expansion treatment.Levosimendan treatment group(n=30):on the basis of conventional treatment,levosimendan rdiontonis therapy was given.The therapeutic effect,cardiac function,renal function and adverse reactions were compared between the two groups.Results:Compared with the conventional treatment group,the treatment effect of levosimendan group was better(P<0.05).The ratio of left ventricular ejection fraction(LVEF)and a-peak velocity of atrial systole(E/A)in levosimendan treatment group were higher than those in conventional treatment group(P<0.05).The left ventricular end diastolic diameter(LVDEd)and left atrial diameter(LAd)in levosimendan group were lower than those in conventional treatment group(P<0.05).The 6-minute walking distance in levosimendan treatment group was higher than that in conventional treatment group(P<0.05).Compared with conventional treatment group,the incidence of adverse reactions was lower in levosimendan treatment group(P<0.05).Conclusion:Levosimendan is safe and effective in the treatment of myocardial infarction complicated with cardio-renal syndrome,which can obviously improve the cardiac function and renal function.