左西孟旦治疗急性失代偿心力衰竭疗效及对患者BNP、CRP、IL-6水平的影响

目的：探讨急性失代偿心力衰竭（ADHF）患者应用左西孟旦治疗的临床效果及对其血浆脑钠肽（BNP）和血清C反应蛋白（CRP）、白介素-6（IL-6）水平的影响。方法：选取某院2014年6月-2016年10月收治的98例ADHF患者，根据随机数字表法均分为2组。对照组：采取常规抗心衰治疗方案；观察组：在此基础上，予以左西孟旦治疗。比较2组临床疗效，治疗前后超声心动图指标、血浆BNP水平、血清炎症因子水平，治疗结束2个月后6 min步行试验（6MWT）结果，及用药安全性。结果：治疗7 d后，观察组总有效率为77.6%，较对照组的53.1%明显提高（P<0.05）。2组治疗7 d后LVESD、LVEDD与治疗前比较，差异均无统计学意义（P>0.05）；与治疗前比较，观察组治疗7 d后LVEF、SV及血浆BNP水平，均显著改善（P<0.01）；对照组治疗7 d后LVEF、血浆BNP水平亦均显著优于治疗前（P<0.01）；且与对照组同期相比，观察组治疗7 d后LVEF、SV及血浆BNP水平改善程度均更为显著（P<0.01）。与治疗前对比，2组治疗7 d后血清CRP、IL-6水平，均显著降低（P<0.01）；且观察组治疗7 d后血清炎症因子水平均显著优于对照组同期（P<0.01）。治疗结束2个月后，观察组6MWT结果显著长于对照组（P<0.01）。观察组治疗期间不良反应率为14.3%与对照组的10.2%相比，差异无统计学意义（P>0.05）。结论： ADHF患者应用左西孟旦治疗更能短期内缓解心衰症状，改善左室功能，保护心脏，降低机体炎症水平，提高运动耐量，效果切实，且安全可靠。

Effect of levosimendan against acute decompensated heart failure and on BNP,CRP, IL-6

OBJECTIVE To explore the clinical effect of levosimendan in patient with acute decompensated heart failure (ADHF) and its effects on the level of brain natriuretic peptide (BNP), brain natriuretic peptide (CRP) and interleukin-6 (IL-6).METHODS Totally 98 cases with ADHF were selected from June 2014 to October 2016 in our hospital and divided into two groups randomly. Routine anti-heart failure therapy was provided to both groups and levosimendan to research group additionally. Clinical efficacy, echocardiographic indicators before and after treatment, serum BNP, serum inflammatory factors before and after treatment, six-minute walking test (6MWT) results 2 months after treatment, and medication safety were observed.RESULTS On the 7th day of therapy, the total effective rate of research group was 77.6%, significantly higher than 53.1% in control group (P<0.05). LVESD and LVEDD on 7 days after treatment showed no statistical significance (P>0.05). LVEF, SV and BNP in treatment group 7 days after therapy were significantly better than those before therapy (P<0.01). LVEF and BNP in control group 7 days after therapy were significantly better than those before therapy (P<0.01). LVEF, SV and BNP in treatment group 7 days after therapy were significantly improved than those of control group (P<0.01). CRP and IL-6 in both groups 7 days after therapy were significant lower than those before therapy (P<0.01). Serum inflammatory factors in treatment group 7 days after therapy were better than those of control group (P<0.01). Two months after therapy, 6MWT result in treatment group was significant better than that of control group (P<0.01). Adverse reaction rate was 14.3% in treatment group and 10.2% in control group (P>0.05).CONCLUSION Levosimendan helps patient to relieve heart failure symptoms, improve left ventricular function, protect the heart, reduce the level of inflammatory factors and improve exercise tolerance, which is effective, safe and reliable.