左西孟旦治疗心力衰竭的临床疗效及对患者心功能及炎性反应的影响

Clinical Efficacy of Levosimendan in the Treatment of Heart Failure and its Effect on Cardiac Function and Inflammatory Response in Patients with Heart Failure

目的研究左西孟旦(LS)治疗心力衰竭(HF)的临床效果。方法纳入2021年9月-2023年8月于都县人民医院收治的68例HF病例,行随机数字表法分为常规组(34例)与LS组(34例),常规组行常规抗心衰治疗,LS组在常规组基础上联合LS治疗,比较两组临床疗效、心功能指标[左室射血分数(LVEF)、二尖瓣舒张早期血流速度/舒张晚期血流速度(E/A)]、炎性反应因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]、6 min步行距离(6MWD)、心力衰竭症状状态问卷(SSQ-HF)评分。结果LS组总有效率高于常规组(P<0.05)。与治疗前相比,两组治疗后LVEF、E/A均有增大(P<0.05),hs-CRP、TNF-α均有下降(P<0.05),且LS组LVEF、E/A大于常规组(P<0.05),hs-CRP、TNF-α低于常规组(P<0.05);与治疗前相比,两组治疗后1个月的6MWD结果均有提升,SSQ-HF评分均有下降(P<0.05),且LS组6MWD结果大于常规组,SSQ-HF评分低于常规组(P<0.05)。结论左西孟旦治疗HF效果肯定,可改善患者心功能,下调机体炎性反应,缓解其心衰症状,值得临床应用。

Objective To investigate the clinical efficacy of levosimendan(LS)in the treatment of heart failure(HF).Methods From September 2021 to August 2023,68 patients with HF admitted to Yudu County People's Hospital were selected and divided into conventional group(34 patients)and LS group(34 patients)by random number table method.The conventional group was treated with conventional anti-heart failure treatment,and the LS group was treated with levosimendan on the basis of the control group.The clinical efficacy,cardiac function indexes[left ventricular ejection fraction(LVEF),mitral early diastolic blood flow velocity/late diastolic blood flow velocity(E/A)],inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],6 min walking distance(6MWD),and heart failure symptom status questionnaire(SSQ-HF)scores were compared between the two groups.Results The total effective rate of the LS group was higher than that of the conventional group(P<0.05).Compared with before treatment,LVEF and E/A in the two groups increased after treatment(P<0.05),hs-CRP and TNF-αdecreased(P<0.05),and LVEF and E/A in the LS group were higher than those in the conventional group(P<0.05),hs-CRP and TNF-αwere lower than those in the conventional group(P<0.05).Compared with before treatment,the 6MWD result of the two groups was improved one month after treatment,and the SSQ-HF scores were decreased(P<0.05).The 6MWD result of the LS group was greater than those of the conventional group,and the SSQ-HF score was lower than that of the conventional group(P<0.05).Conclusion Levosimendan is effective in the treatment of HF.It can improve the cardiac function of patients,down-regulate the body's inflammatory response,and relieve the symptoms of heart failure.It is worthy of clinical application.