左西孟旦治疗急性失代偿性心力衰竭的疗效及其安全性评估

Therapeutic effect of levosimendan on acute decompensated heart failure and its safety assessment

目的:评估左西孟旦治疗急性失代偿性心力衰竭(ADHF)急性期患者的疗效及其安全性。方法:入选200名ADHF患者,随机均分为常规治疗组和左西孟旦组(在常规治疗基础上给予左西孟旦治疗),治疗5d后,观察比较两组临床症状缓解程度,脑钠肽(BNP)水平,以及治疗后平均住院时间与不良事件发生率。结果:治疗5d后,与常规治疗组比较,左西孟旦组临床症状改善比例(44%比59%)显著增加,BNP水平[353(314,393)pg/ml比326(284,374)pg/ml]显著降低;治疗后平均住院时间[(7.7±0.9)d比(7.1±1.0)d]显著减少,P<0.05或<0.01;不良事件发生率:左西孟旦组头痛(15.0%比30.0%)、心房颤动(2.0%比9.0%)比例显著升高(P均<0.05)。结论:在急性左心衰竭患者的急性期,静脉注射左西孟旦可迅速且持久地缓解症状,但需密切监测不良事件发生。

Objective:To assess therapeutic effect of levosimendan on patients with acute decompensated heart failure(ADHF)of acute phase and its safety.Methods:A total of 200 ADHF patients were randomly and equally divided into routine treatment group and levosimendan group(received levosimendan therapy based on routine treatment).After 5d treatment,clinical symptom relieving extent,level of brain natriuretic peptide(BNP);and after treatment,mean hospital stay and incidence of adverse events were observed and compared between two groups.Results:After 5d treatment,compared with routine treatment group,there was significant rise in percentage of improved clinical symptoms(44%vs.59%),and significant reductions in BNP level[353(314,393)pg/ml vs.326(284,374)pg/ml]and after treatment mean hospital stay[(7.7±0.9)d vs.(7.1±1.0)d],P<0.05 or<0.01;and significant rise in percentages of headache(15.0%vs.30.0%)and atrial fibrillation(2.0%vs.9.0%)in levosimendan group,P<0.05 both.Conclusion:During acute phase of ADHF,intravenous injection of levosimendan can relieve symptoms rapidly and persistently,but adverse events call for closely monitor.