左西孟旦、冻干重组人脑利钠肽、米力农对慢性心力衰竭患者的血流动力学失代偿状态及不良反应发生情况的影响

目的探讨左西孟旦、冻干重组人脑利钠肽、米力农对慢性心力衰竭(CHF)患者的血流动力学失代偿状态及不良反应发生情况的影响。方法选取2015年7月至2018年7月我院186例CHF患者为研究对象,对其临床资料进行回顾性研究,根据不同的用药方案将受试者分为左西孟旦组、冻干重组人脑利钠肽组及米力农组,每组62例,比较三组患者的临床疗效、治疗前、后血流动力学指标、左室射血分数(LVEF)、N末端B型利钠肽原(NT-proBNP)水平及不良反应发生情况。结果左西孟旦组的治疗总有效率显著高于米力农组与冻干重组人脑利钠肽组,差异具有统计学意义(P<0.05)。治疗后,三组患者的PCWP、PAMP、RAP及SVR均降低,差异具有统计学意义(P<0.05);治疗后,左西孟旦组的PCWP、PAMP及SVR低于米力农组与冻干重组人脑利钠肽组,差异具有统计学意义(P<0.05)。治疗后,三组的LVEF均升高,NT-proBNP水平均降低,且左西孟旦组优于米力农组与冻干重组人脑利钠肽组,差异具有统计学意义(P<0.05)。左西孟旦组的不良反应总发生率显著低于米力农组与冻干重组人脑利钠肽组,差异具有统计学意义(P<0.05)。结论左西孟旦改善CHF患者心功能及血流动力学指标的效果优于冻干重组人脑利钠肽和米力农,且其安全性高,在CHF患者的治疗中具有较高的应用价值。

Effects of levosimendan,lyophilized recombinant human brain natriuretic peptide and milinone on hemodynamic decompensation and adverse reactions in patients with chronic heart failure

Objective To investigate the effects of levosimendan, lyophilized recombinant human brain natriuretic peptide and milinone on hemodynamic decompensation and adverse reactions in patients with chronic heart failure(CHF). Methods From July 2015 to July 2018, 186 patients with CHF in our hospital were selected as the research objects, the clinical data were retrospectively studied. The objects were divided into levosimendan group, lyophilized recombinant human brain natriuretic peptide group and milinone group according to different medication regimens, with 62 cases in each group. The clinical efficacy, hemodynamic indexes, left ventricular ejection fraction(LVEF), N-terminal pro-B-type natriuretic peptide(NT-proBNP) levels before and after treatment and adverse reaction were compared among the three groups. Results The total effective rate of treatment in the levosimendan group were significantly higher than that in the milinone group and the lyophilized recombinant human brain natriuretic peptide group, the differences were statistically significant(P<0.05). After treatment, the PCWP, PAMP, RAP and SVR of patients of the three groups reduced, and the differences were statistically significant(P<0.05);after treatment, the PCWP, PAMP and SVR of the levosimendan group were lower than those of the milinone group and the lyophilized recombinant human brain natriuretic peptide group, the differences were statistically significant(P<0.05). After treatment, the LVEF in all three groups increased, and the levels of NT-proBNP decreased, and those in the levosimendan group were better than the milinone group and the lyophilized recombinant human brain natriuretic peptide group, and the differences were statistically significant(P<0.05). The total incidence of adverse reactions in the levosimendan group were significantly lower than that in the milinone group and the lyophilized recombinant human brain natriuretic peptide group, the differences were statistically significant(P<0.05). Conclusion Levosimendan is superior to lyophilized recombinant human brain natriuretic peptide and milrinone in improving the cardiac function and hemodynamic indexes of CHF patients, and which has high safety and high application value in the treatment of CHF patients.