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左西孟旦治疗急性左心衰的临床观察
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| 篇名： | 左西孟旦治疗急性左心衰的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨左西孟旦治疗急性左心衰的疗效及安全性，以及对左心功能指标和血清标志物的影响。方法：选取2014年1月－2015年12月解放军第251医院收治的急性左心衰患者110例为研究对象，按照随机数字表法分为对照组（53例）和观察组（57例）。两组患者均给予常规药物治疗。对照组患者在常规治疗基础上给予盐酸多巴胺注射液或盐酸多巴酚丁胺注射液强心；观察组患者在常规治疗基础上给予左西孟旦注射液初始负荷剂量10 μg/kg+0.9％氯化钠注射液50 mL，ivgtt（10 min），之后改微量泵泵注，速率0.1 μg/（kg·min），持续给药24 h。两组患者均连续治疗7 d。观察两组患者临床疗效，治疗前后的左心功能指标[峰射血率（PER）、峰充盈率（PFR）、左室射血分数（LVEF）和左室短轴缩短率（LVSF）]水平、血清标志物[N-末端脑钠肽前体（NT-proBNP）和半乳糖凝集素3（Gal-3）]水平，并记录不良反应发生情况。结果：两组患者因死亡脱落2例（每组各1例），最终纳入统计的合格病例数为108例，其中对照组52例、观察组56例。观察组患者的临床总有效率（94.64％）高于对照组（86.54％），但差异无统计学意义（P＞0.05）。治疗前，两组患者左心功能指标和血清标志物水平比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者上述左心功能指标水平均显著升高，且观察组的LVEF 和LVSF 显著高于对照组，差异均有统计学意义（P＜0.05）；两组患者NT-proBNP和Gal-3均显著降低，且观察组显著低于对照组，差异均有统计学意义（P＜0.05）。两组患者治疗过程中均未见明显的不良反应发生。结论：左西孟旦治疗急性左心衰疗效与多巴胺相似，但有助于增强左心泵血功能，降低心衰标志物水平，且安全性较高。 |
| ABSTRACT： | OBJECTIVE： To investigate therapeutic efficacy and safety of leosimendan in the treatment of acute left heart failure （ALHF） and its effects on left ventricular function indexes and serum markers. METHODS： A total of 110 patients with acute left ventricular function selected as research objects from No. 251 Hospital of PLA during Jan. 2014-Dec. 2015， and then were divided into control group （53 cases） and observation group （57 cases） according to random number table. Both groups received routine therapy. Control group was additionally given Dopamine hydrochloride injection or Dobutamine hydrochloride injection as cardiotonic on the basis of routine therapy. Observation group was additionally given Levosimendan injection with initial dose of 10 μg/kg+0.9％ Sodium chloride injection 50 mL， ivgtt （10 min）， and then with micro pump infusion at the rate of 0.1 g/ （kg·min） for continuous 24 h. Both groups were treated for continuous 7 d. Clinical efficacies of 2 groups were observed， and the levels of left ventricular function indexes （PER， PFR， LVEF， LVSF） level， serum marker （NT-proBNP） and galectin-3 （Gal-3） before and after treatment， the occurrence of ADR was recorded. RESULTS： Two cases were withdrawn from the study due to death （one case in each group）. Finally， a total of 108 cases were included， involving 52 cases in control group and 56 cases in observation group. Clinical total response rate of observation group （94.64％） was higher than that of control group （86.54％）， but without statistical significance （P＞0.05）. Before treatment， there was no statistical significance in left ventricular function indexes or serum markers levels between 2 groups （P＞0.05）. After treatment， the levels of left ventricular function indexes were improved significantly in 2 groups， and LVEF and LVSF of observation group were significantly higher than those of control group， with statistical significance （P＜0.05）. NT-proBNP and Gal-3 of 2 groups were decreased significantly， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS： Leosimendan in the treatment of ALHF have the similor clinical efficacy with dopamine， but helps to strengthen the left heart pump function， reduce heart failure markers levels with good safety. |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 段金旗，马丽琼，陈媛媛，任炜，刘远林，徐昌富 |
| AUTHORS： | DUAN Jinqi，MA Liqiong，CHEN Yuanyuan，REN Wei，LIU Yuanlin，XU Changfu |
| 关键字： | 急性左心衰；左西孟旦；多巴胺；多巴酚丁胺；左室射血分数；N-末端脑钠肽前体；半乳糖凝集素3 |
| KEYWORDS： | Acute left heart failure； Levosimendan； Dopamine； Dobutamine； Left ventricular ejection fraction； Nterminal pro-brain natriuretic peptide； Galectin-3 |
| 阅读数： | 412 次 |
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