CAJ | 학술논문

心脏外科手术中体外循环后心功能障碍的病人常需要正性肌力药物的支持.传统的正性肌力药由于存在增加心肌氧耗和致心律失常的危险,临床应用受到一定限制.左西孟旦,一种新型强心剂-钙增敏剂,其强心作用机制是增加心肌收缩蛋白对钙离子的敏感性,并通过激活KATP发挥扩血管和抗缺血效应.现有的临床资料表明左西孟旦在治疗术中高危或合并左心功能不全的心脏手术病人以及帮助病人顺利脱离体外循环方面具有很好的应用前景.
심장외과수술중체외순배후심공능장애적병인상수요정성기력약물적지지.전통적정성기력약유우존재증가심기양모화치심률실상적위험,림상응용수도일정한제.좌서맹단,일충신형강심제-개증민제,기강심작용궤제시증가심기수축단백대개리자적민감성,병통과격활KATP발휘확혈관화항결혈효응.현유적림상자료표명좌서맹단재치료술중고위혹합병좌심공능불전적심장수술병인이급방조병인순리탈리체외순배방면구유흔호적응용전경.
Patients suffering from ventricular dysfunction after cardiac surgery with cardiopulmonary bypass (CPB) often require positive inotropic support. The use of conventional inotropic agents is limited in clinic because of their increasing myocardial oxygen consumption and/or proarrhythmia. Levosimendan, a member of new class (calcium sensitizer) of inotropic agents, enhances cardiac contractility via increasing calcium sensitization of contractile proteins, and produces vasodilation and anti-ischemia effect by opening KATP channel. The available clinical evidences show that levosimendan is effective for treatment of cardiac surgical patients with high perioperative risk or compromised left ventricular function, and rescues patients with difficulties in weaning from CPB.