左西孟旦治疗联合酚妥拉明治疗肺心病引起右心衰竭的临床分析

Clinical Analysis of Right Heart Failure Caused by Pulmonary Heart Disease Treated with Levosimendan Combined with Phentolamine

目的研讨左西孟旦与酚妥拉明共同治疗肺心病引起右心衰竭的临床效果。方法选择开封市人民医院2022年1月至2022年12月收入的72例肺心病引起右心衰竭患者,按随机数字表法分成三组,对照组、单一组和联合组,各24例。对照组应用常规心衰治疗,单一组在对照组基础上加用左西孟旦,联合组在单一组基础上加用酚妥拉明,比较三组临床疗效、心功能、血气指标、不良反应发生率。结果联合组治疗有效率(95.83%),高于单一组(79.17%)、对照组(66.67%),差异有统计学意义(P<0.05);三组治疗前左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、6分钟步行距离水平(6MWT)值比较,差异无统计学意义(P>0.05),治疗后联合组6MWT值高于对照组和单一组,LVEDD、LVESD值低于对照组和单一组,差异有统计学意义(P<0.05);三组治疗前左室射血分数(LVEF)、右室射血分数(RVEF)、血浆B型钠尿肽(BNP)正常率比较,差异无统计学意义(P>0.05),治疗后联合组LVEF、RVEF、BNP正常率分别为83.33%、79.17%、41.67%,高于单一组和对照组的62.50%和37.50%、62.50%和33.33%、20.83%和8.33%,差异有统计学意义(P<0.05);治疗前三组氧分压(PO_(2))、二氧化碳分压(PCO_(2))正常率比较,差异无统计学意义(P>0.05),治疗后联合组PO_(2)、PCO_(2)正常率分别为79.17%、91.67%,高于单一组和对照组的58.33%和33.33%、66.67%和41.67%,差异有统计学意义(P<0.05);三组不良反应发生率对比,差异无统计学意义(P>0.05)。结论左西孟旦、酚妥拉明共同治疗肺心病引起右心衰竭疗效显著,能改良心功能和血气指标,有较高的用药安全性。

Objective To study the clinical effect of levosimendan and phentolamine in the treatment of right heart failure caused by pulmonary heart disease.Methods A total of 72 patients with right heart failure caused by pulmonary heart disease were selected from Kaifeng People's Hospital from January 2022 to December 2022 and divided into three groups according to random number table method:control group,single group and combination group,with 24 cases each.The control group was treated with conventional heart failure treatment,the single group was treated with levosimendan on the basis of the control group,and the combined group was treated with phentolamine on the basis of the single group.The clinical efficacy,heart function,blood gas indicators,and the incidence of adverse reactions were compared between the three groups.Results The effective rate of combination group(95.83%)was higher than that of single group(79.17%)and control group(66.67%),the difference was statistically significant(P<0.05).There was no significant difference in left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and 6-minute walking distance(6MWT)between the three groups before treatment(P>0.05).After treatment,the 6MWT value of the combined group was higher than that of the control group and single group,and the LVEDD and LVESD values were lower than that of the control group and single group.The difference was statistically significant(P<0.05).There was no significant difference in left ventricular ejection fraction(LVEF),right ventricular ejection fraction(RVEF)and plasma B type natriuretic peptide(BNP)normal rates among the three groups before treatment(P>0.05).After treatment,the normal rates of LVEF,RVEF and BNP in the combined group were 83.33%,79.17% and 41.67%,respectively.Those in single group and control group were 62.50%and 37.50%,62.50% and 33.33%,20.83% and 8.33%,and the difference was statistically significant(P<0.05).There was no significant difference in the normal rates of oxygen partial pressure(PO_(2))and carbon dioxide partial pressure(PCO_(2))among the three groups before treatment(P>0.05).After treatment,the normal rates of PO_(2) and PCO_(2) in the combined group were 79.17% and 91.67%,respectively.It was higher than of the single group(58.33% and 33.33%)and the control group(66.67% and 41.67%),and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Levosimendan and phentolamine are effective in the treatment of right heart failure caused by pulmonary heart disease,and can improve cardiac function and blood gas indexes,and have high drug safety.