摘要
目的探究左西孟旦对慢性心力衰竭（心衰）患者心肌损伤和心功能的影响。方法选择2014年3月~2016年1月在山东省单县东大医院进行住院治疗的慢性心衰患者70例，其中男性39例，女性31例，年龄53~76岁。所有患者随机分为2组，左西孟旦组（36例）和对照组（34例）。对照组采用常规抗心衰药物治疗，左西孟旦组在此基础上加用左西孟旦。治疗后评价两组临床疗效，并于治疗前后检测两组心肌肌钙蛋白T（cTnT）、类胰岛素生长因子-1（IGF-1）、N末端脑钠肽前体（NT-proBNP）水平以及左室射血分数（LVEF）、每搏心输出量（SV）、左室舒张末期内径（LVEDD）及左室收缩末期内径（LVESD）等指标。结果治疗结束后，左西孟旦组总有效率为83.33%，高于对照组的73.53%，差异具有统计学意义（P＜0.05）。两组治疗后较治疗前cTnT及NT-proBNP水平均降低，IGF-1升高，差异有统计学意义（P均＜0.05）。与对照组治疗后比较，左西孟旦组cTnT及NT-proBNP水平下降，IGF-1升高，差异有统计学意义（P均＜0.05）。两组治疗后较治疗前LVEF和SV均增加，差异有统计学意义（P均＜0.05）。治疗后，左西孟旦组较对照组SV增加，（76.32±15.37）mlvs.（65.45±13.58）ml，差异有统计学意义（P＜0.05）。治疗期间两组患者并未出现明显的不良反应。结论在传统药物基础上加用左西孟旦治疗慢性心力衰竭患者能够显著改善心脏收缩能力，减轻心肌损伤，疗效显著，值得积极推广。
Objective To study the influence of levosimendan on myocardial injury and heart function in patients with chronic heart failure (CHF). Methods CHF patients (n=70, male 39, female 31 and aged from 53 to 76) were chosen from Dongda Hospital in Shan Country of Shandong Province from Mar. 2014 to Jan. 2016,and randomly divided into levosimendan group (n=36) and control group (n=34). The control group was treated with routine anti-CHF drugs, and levosimendan group, additionally with levosimendan. The curative effect was reviewed, and the levels of cardiac troponin T (cTnT), insulin-like growth factor-1 (IGF-1), N-terminal pro-brain natriuretic peptide (NT-proBNP), and indexes of left ventricular ejection fraction (LVEF), stroke volume (SV), left ventricular end-diastolic inner diameter (LVEDd) and left ventricular end-systolic diameter (LVESd) were detected in 2 groups before and after treatment. Results The total effective rate was 83.33% in levosimendan group and 73.53% in control group (P<0.05) after treatment. The levels of cTnT and NT-proBNP decreased and level of IGF-1 increased in 2 groups after treatment (all P<0.05). The levels of cTnT and NT-proBNP decreased and level of IGF-1 increased in levosimend an group compared with control group after treatment (all P<0.05). LVEF and SV increased in 2 groups after treatment (all P<0.05). SV increased in levosimendan group compared with control group [(76.32±15.37) mL vs. (65.45±13.58) mL] after treatment (P<0.05). There were no patients with adverse reactions observed in 2 groups. Conclusion Levosimendan administrated on the base of traditional drugs can significantly improve cardiac contractility and relieve myocardial injury with higher curative effect, which is worth clinical promoting.
作者
徐凤兰
杨光全
赵燕
XU Feng-lan;YANG Guan-quan;ZHAO Yan(Department of Pharmaceutics, Dongda Hospital, Shan Country,Shandong Province, Heze 274300, China)
出处
《中国循证心血管医学杂志》
2016年第8期974-976,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
