左西孟旦在围产期心肌病患者中的临床疗效和安全性

Clinical efficacy and safety of levosimendan in patients with peripartum cardiomyopathy

本研究旨在探讨左西孟旦在治疗围产期心肌病患者中的临床疗效和安全性。选择62例围产期心肌病患者作为研究对象。根据药物使用情况分为实验组(n=30)及对照组(n=32),两组均给予常规治疗。实验组在常规治疗的基础上加用左西孟旦12.5 mg,每周一次。治疗14天后,观察两组患者治疗前后cTNI、BNP水平及心脏结构和功能变化。同时观察实验组有无不良反应,如低血压、室性心律失常、过敏等。结果显示,与对照组相比,实验组应用左西孟旦后,PPCM患者左室射血分数明显增高,左心房内径、左室舒张末内径和肺动脉压力均显著减低(P<0.05)。血清cTNI和BNP均明显下降(P<0.01)。1例患者出现一过性低血压。研究表明左西孟旦可以明显改善围产期心肌病患者的心功能,逆转心脏结构重构,安全性和耐受性良好。

In the present study,we aimed to explore the efficacy and safety of levosimendan for patients with peripartum cardiomyopathy(PPCM).Overall,62 cases with PPCM were selected as the research subjects and randomly divided into an experimental group(30 cases)and a control group(32 cases).The groups differed only in terms of the use of levosimendan.Both groups received conventional therapy.Besides,the experimental group was administered 12.5 mg of levosimendan once a week.The levels of high-sensitivity troponin I(cTnI)and B-type brain natriuretic peptide(BNP)and their cardiac structure and function in the two groups were evaluated before and after treatment.Concurrently,the experimental group was observed for adverse reactions,such as hypotension,ventricular arrhythmia,and allergy.After 14 d of treatment,the experimental group,when compared with the control group,showed significantly increased left ventricular ejection fraction and significantly lower left ventricular internal diameter,left atrial anteroposterior diameter,and pulmonary artery pressure(P<0.05).Serum cTnI and BNP were also significantly decreased(P<0.01).Transient hypotension occurred in one patient.Through this study,we concluded that levosimendan could significantly improve cardiac function and reverse cardiac remodeling in patients with PPCM,and this approach had good levels of safety and tolerance.