摘要
目的探讨应用左西孟旦治疗老年扩张型心肌病(DCM)合并肾功能不全患者的疗效和安全性。方法选择老年DCM患者32例,均合并不同程度肾功能不全,分为观察组16例和对照组16例。在常规抗心力衰竭药物治疗基础上,观察组给予左西孟旦治疗,对照组给予多巴酚丁胺治疗。两组患者治疗前和治疗1周后分别监测血压、心率、左心室射血分数(LVEF)、血浆N末端脑钠肽前体(NT-proBNP)、血肌酐(Scr)和肾小球滤过率(eGFR),并进行比较。结果治疗后观察组LVEF、Scr、eGFR水平明显高于对照组,NT-proBNP水平明显低于对照组,差异均有统计学意义(均P<0.05);治疗后两组血压、心率及不良反应率比较,差异均无统计学意义(均P>0.05)。结论左西孟旦可改善老年DCM合并肾功能不全患者的血流动力学及心功能,同时肾功能也得到改善;左西孟旦治疗老年DCM合并肾功能不全患者是安全有效的。
Objective To evaluate the efficacy and safety of levosimendan in the treatment of elderly patients with dilated cardiomyopathy and renal insufficiency.Methods Thirty two elderly patients with dilated cardiomyopathy and renal insufficiency were randomly divided into study group and control group with 16 cases in each group.On the basis of conventional anti heart failure drug treatment,the study group was given with levosimendan and the control group was given with dobutamine.The blood pressure,heart rate,left ventricular ejection fraction(LVEF),plasma N terminal-pro brain natriuretic peptide(NT-proBNP),serum creatinine(Scr)and glomerular filtration rate(eGFR)were measured and compared between the two groups before and 1 week after treatment.Results After treatment the LVEF in study group was significantly higher than that in the control group(35.9%vs 33.1%,P<0.05),the NT-proBNP level was significantly lower than that of the control group(1910.6 pg/ml vs 2389.3 pg/ml,P<0.05),and eGFR was significantly increased compared with the control group(58.5μmmol/L vs 52.4μmmol/L,P<0.05).However,there were no significant differences in blood pressure,heart rate and adverse reactions after treatment between two groups(P>0.05).Conclusion Levosimendan can improve hemodynamics and cardiac function,as well as renal function in elderly patients with dilated cardiomyopathy and renal insufficiency.
作者
何浪
陈志平
陈宇宁
许峥贵
欣明花
钟诚
沈法荣
HE Lang;CHEN Zhiping;CHEN Yuning(Department of Cardiology,Zhejiang Greentown Cardiovascular Hospital,Hangzhou 310012,China)
出处
《浙江医学》
CAS
2019年第4期359-361,共3页
Zhejiang Medical Journal
关键词
扩张型心肌病
肾功能不全
心力衰竭
左西孟旦
Dilated cardiomyopathy
Renal insufficiency
Heart failure
Levosimendan
