左西孟旦治疗急性失代偿性心力衰竭近期疗效评价

目的：探讨左西孟旦治疗急性失代偿性心力衰竭（ADHF）的疗效性和安全性。方法：85例ADHF患者随机分为研究组和对照组。对照组给予基础治疗,研究组在此基础上加用左西孟旦注射液治疗24 h。比较两组治疗后7 d的左室射血分数（LVEF）、每搏量（SV）、左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）、B型利钠肽（BNP）、24 h尿量和NYHA心功能变化情况,评价两组疗效和药品不良反应。结果：两组治疗后LVEF、BNP和24h尿量均较前有明显改变（P〈0.05）。两组治疗后LVEF、BNP和24 h尿量比较,差异均有统计学意义（P〈0.05）,但SV、LVESD和LVEDD比较差异无统计学意义（P〉0.05）。两组治疗前后NYHA心功能分级比较,差异均有统计学意义（P〈0.05）,两组治疗后比较,差异也有统计学意义（P〈0.05）。研究组和对照组的总有效率分别为72.09%和54.77%,但差异无统计学意义（P〉0.05）。两组不良反应发生率分别为30.23%和11.90%,差异有统计学意义（P〈0.05）。结论：左西孟旦治疗ADHF能改善心脏功能,但应注意低血压和心律失常的发生。

The Short term Effect of Leosimendan in the Treatment of Acute Decompensated Heart Failure

Objective ：To evaluate the efficacy and safety of leosimendan in the treatment of acute decompensated heart failure. Methods：85 cases with acute decompensated heart failurewere randomly divided into study group and control group. The control group were treated with conventional medicines, and the study group were given leosimendan additional- ly for 24h. The changes of LVEF, SV, LEEDD, LVESD, BNP, 24 h urine volume and NYHA classification were evalua- ted, as well as efficacy and safety. Results： The values of LVEF, BNP, 24 h urine volume and NYHA classification changed more obviously than those before treatment （ P 〈 0.05 ）, but the SV and LVEDD produced almost no change （ P 〉 0.05 ）. There were still significantly differences in LVEF, BNP, 24 h urine volume and NYHA Classification compared be- tween groups after treatment （ P 〈 0.05 ）, but there were no significantly differences in SV, LVESD and LVEDD compared between two groups after treatment（ P 〉0.05 ）. The total effective rate was 72.09% in study group, higher than 54.77% in control group. But there was no statistical difference between the two groups （ P 〉 0.05 ）. The rate of adverse reaction was 30.23% （ 13/43）, higher than 11.90% （5/42） in control group （P 〈0.05）. Conclusion： Leosimendan in the treat- ment of acute decompensated heart failure can significantly improve heart function, but we should pay more attention to the occurrence of low blood pressure and cardiac arrhythmias.