静脉注射左西孟旦治疗重度失代偿性心力衰竭患者的疗效

摘要

Objective:To explore the effectiveness and safety of levosimendan treating severe decompensated heart failure (SDHF) .Methods :A total of 80 patients with SDHF caused by various caused were selected ,randomly and equally divided into levosimendan group and dobutamine group .Both groups received intravenous drip of corre‐sponding drug based on routine treatment ,and the course was 24h .After two weeks ,therapeutic effects were com‐pared between two groups .Results:After two weeks ,total effective rate of levosimendan group was significantly higher than that of dobutamine group (95.0% vs .72.5% , P= 0.005) .Compared with dobutamine group ,after two weeks , there were significant reductions in dyspnea status score [ (2.57 ± 0.80 ) scores vs . (1.89 ± 0.70 ) scores] ,general status score [(3.23 ± 0.65) scores vs .(2.95 ± 1.29) scores] ,respiratory frequency [(24.32 ± 0.98) times/min vs .(20.6 ± 1.58) times/min] and level of brain natriuretic peptide [(1584 ± 325.63) mg/ml vs .(1011.92 ± 302.31) mg/ml] ,and significant rise in left ventricular ejection fraction [(40.16 ± 4.85)% vs .(46.53 ± 3.37)% ] in levosimendan group , P<0.05 or <0.01. Conclusion:In short-term therapeutic effect on severe decompensated heart failure ,levosimendan is superior to dobutamine ,it possesses good safety and tolerance ,which can be used as an effective drug for severe decompensated heart failure .%目的：探讨左西孟旦治疗重度失代偿性心衰的有效性及安全性。方法：选择各种原因导致的重度失代偿性心力衰竭患者80例，随机均分为左西孟旦组和多巴酚丁胺组。两组均在常规治疗的基础上，静脉滴注相应药物。疗程24h ，两周后比较两组治疗效果。结果：2周后左西孟旦组总有效率明显高于多巴酚丁胺组（95.0％比72.5％， P＝0.005），与多巴酚丁胺组比较，2周后左西孟旦组呼吸困难状况评分[（2.57±0.80）分比（1.89±0.70）分]和全身状况评分[（3.23±0.65）分比（2.95±1.29）分]明显减少，呼吸频率[（24.32±0.98）次／min比（20.6±1.58）次／min]和脑钠肽[（1584±325.63） mg／ml比（1011.92±302.31）mg／ml]水平明显下降，左室射血分数[（40.16±4.85）％比（46.53±3.37）％]明显提高，P＜0.05或＜0.01。结论：左西孟旦在治疗重度失代偿心力衰竭的短期疗效优于传统正性肌力药多巴酚丁胺，安全性及耐受性良好，是治疗重度失代偿心力衰竭的有效药物。