摘要
目的探讨左西孟旦对难治性心力衰竭患者血N末端-脑钠肽前体（NT-proBNP）和乳酸清除率的影响。方法将86例难治性心力衰竭患者按照数字表法随机分为对照组和观察组，每组43例，对照组采用基础治疗加米力农，观察组采用基础治疗加左西孟旦。测定患者每搏输出量（SV）、心输出量（CO）、心脏指数（CI）、左室射血分数（LVEF）及左室舒张末期内径（LVDD）。治疗前后测定血NT—proBNP和乳酸清除率。结果两组治疗后SV、CO、CI、LVEF及LVDD均有明显改善，并且治疗后观察组SV、CO、CI、LVEF改善更明显（P〈0．05），两组治疗后LVDD比较差异无统计学意义（P〉0．05）。观察组住院天数、30d住院例数均少于对照组（P〈0．05），两组出院后30d全因死亡例数比较差异无统计学意义（P〉0．05）。对照组总有效率为81．4％，观察组为93．0％，两组比较差异有统计学意义（P〈0．05）。两组血浆NT—proBNP治疗后均明显降低，并且观察组降低更明显（P〈0．05），观察组治疗后乳酸清除率明显高于对照组（P〈0．05）。结论左西孟旦可以明显降低难治性心力衰竭患者血NT-proBNP和提高乳酸清除率。
Objective To study the effect of levosimendan on N-terminal-brain natriuretic peptide（NT-proBNP） and blood lactate clearance rate in patients with refractory heart failure. Methods Eighty-six patients with refractory heart failure were randomly divided into two groups, the control group and the observation group, with 43 cases in each group. The patients in the control group were treated by the conventional treatment and milrinone, while the patients in the observation group were treated by the conventional treatment and levosimendan. The stroke volume determination （SV）, cardiac output （CO）, cardiac index （CI）, left ventricular ejection fraction （LVEF） and left ventricular diastolic diameter （LVDD） were compared. Serum NT-proBNP levels and lactate clearance rates were detected before and after treatment. Results After treatment, the levels of SV, CO, CI, LVEF and LVDD were significantly improved and those in the observation group were improved more significantly （ P 〈 0. 05 ）. After treatment, LVDD had no significant difference between the two groups （ P 〉 0. 05 ）. The days in hospital, the numbers of hospitalizations with 30 days in the observation group were less than those in the control group （P 〈 O. 05 ）, the all-cause mortality after discharge 30 d had no significant difference between the two groups（ P 〉 0. 05）. The total effective rate was 81.4% in the control group and 93.0% in the observation group, the difference was significant （P 〈 0. 05 ）. The plasma NT-proBNP levels were significantly reduced after treatment, and those in the observation group were decreased more significantly （P 〈 0.05 ）, after treatment, the lactate clearance rate was significantly higher in the observation group than that in the control group （ P 〈 0.05 ）. Conclusions Levosimendan can significantly decrease the serum NT-proBNP level and blood lactate clearance rate in patients with refractory heart failure.
出处
《中国实用医刊》
2014年第15期7-9,共3页
Chinese Journal of Practical Medicine
关键词
心力衰竭
左西孟旦
N末端-脑钠肽前体
乳酸清除率
Heart failure
Levosimendan
N-terminal-brain natriuretic peptide
Lactate clearance rate
