左西孟旦在老年急性左心衰竭患者中的应用

Levosimendan in the elderly patients with acute left heart failure

摘要:

目的 评价左西孟旦治疗老年急性左心衰竭的临床疗效。方法 选取2011年6月至2013年6月在第四军医大学西京医院老年病科住院的急性左心衰竭患者72例，其中男49例、女23例，年龄65～87（75.1±9.8）岁。将其随机分为对照组和左西孟旦组（n＝36），对照组给予常规抗心力衰竭治疗，左西孟旦组在常规抗心力衰竭治疗的基础上加用左西孟旦。观察两组患者的临床疗效、每搏心输出量（SV）、左室射血分数（LVEF）及N-末端脑钠肽前体（NT-pro-BNP）的改善情况。结果 治疗后两组患者的心力衰竭症状和体征均有显著改善。SV及LVEF明显提高（P＜0.05），NT-pro-BNP下降明显（P＜0.05）。左西孟旦组的总有效率显著高于对照组（94.4% vs 69.4%，P＜0.05）。与对照组比较，左西孟旦治疗组SV及LVEF显著提高（P＜0.05），NT-pro-BNP下降更明显（P＜0.05）。结论 左西孟旦注射液治疗老年急性左心衰竭患者疗效确切，安全性好。

Abstract:

Objective To evaluate the efficiency of levosimendan on the heart function in the elderly patients with acute left heart failure. Methods Seventy-two elderly patients with acute left heart failure hospitalized in our department from June 2011 to June 2013 were enrolled in this study. There were 49 males and 23 females, with an age of 65 to 87 (75.1±9.8) years. These patients were randomly assigned into 2 groups, control and levosimendan group (n＝36). Control group accepted conventional therapy to treat acute left heart failure. Levosimendan group accepted levosimendan besides the same conventional therapy as in control group. The difference of clinical symptoms and signs of acute heart failure, cardiac output stroke volume (SV), left ventricular ejection fraction (LVEF) and serum level of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were compared between the 2 groups. Results Clinical symptoms and signs of acute left heart failure were improved significantly after treatment. SV and LVEF were increased, while the serum level of NT-pro-BNP was decreased significantly in both groups (P＜0.05). But the total effective rate was significantly higher in the levosimendan group than in the control group (94.4% vs 69.4%, P＜0.05). Compared with control group, the increase of SV and LVEF, and the decrease of NT-pro-BNP was more significant in levosimendan group (P＜0.05). Conclusion Levosimendan controls the symptoms and signs of acute left heart failure with great efficiency and safety.