左西孟旦治疗老年重症顽固性心力衰竭的疗效研究

Efficacy of levosimendan in the treatment of severe intractable heart failure in the elderly

目的分析老年重症顽固性心力衰竭患者采用左西孟旦治疗的临床效果。方法76例老年重症顽固性心力衰竭患者,采用随机数字表法分为对照组和观察组,各38例。对照组采用常规治疗,观察组在对照组基础上联合应用左西孟旦治疗。比较两组治疗效果,治疗前后心功能参数[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)]、血清脑钠肽、尿酸水平。结果观察组治疗总有效率94.74%高于对照组的78.95%,差异具有统计学意义(P<0.05)。治疗后,观察组LVEF(47.95±6.18)%大于对照组的(41.63±5.06)%,LVESD(36.59±3.69)mm、LVEDD(46.26±4.19)mm小于对照组的(41.29±5.03)、(51.79±5.03)mm,差异具有统计学意义(P<0.05)。治疗后,观察组脑钠肽水平(249.16±25.36)μg/L、尿酸水平(281.53±28.06)μmol/L低于对照组的(459.19±28.63)μg/L、(352.16±30.25)μmol/L,差异具有统计学意义(P<0.05)。结论对老年重症顽固性心力衰竭患者应用左西孟旦治疗可显著提升疗效,并改善心功能,值得临床推广应用。

Objective To analyze the clinical effect of levosimendan in the treatment of severe intractable heart failure in the elderly.Methods A total of 76 elderly patients with severe refractory heart failure were randomly divided into control group and observation group by random numerical table,with 38 cases in each group.The control group was treated with conventional treatment,and the observation group was treated with levosimendan on the basis of the control group.Both groups were compared in terms of therapeutic effects,cardiac function parameters[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)],serum brain natriuretic peptide and uric acid levels before and after treatment.Results The total effective rate 94.74%of the observation group was higher than 78.95%of the control group,and the difference was statistically significant(P<0.05).After treatment,the LVEF(47.95±6.18)%of the observation group was greater than(41.63±5.06)%of the control group;the LVESD(36.59±3.69)mm and LVEDD(46.26±4.19)mm of the observation group were smaller than(41.29±5.03)and(51.79±5.03)mm of the control group;all the differences were statistically significant(P<0.05).After treatment,the brain natriuretic peptide(249.16±25.36)μg/L and uric acid(281.53±28.06)μmol/L in the observation group were lower than(459.19±28.63)μg/L and(352.16±30.25)μmol/L in the control group,and the differences were statistically significant(P<0.05).Conclusion Levosimendan can significantly improve the efficacy of patients with severe intractable heart failure,and improve the cardiac function,which is worthy of clinical promotion and application.