中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
2期
153-156
,共4页
张宇辉%张健%卿恩明%黎辉%孙英贤%张麟%白小涓%刘文娴%姜一农%曲鹏%韦丙奇%周琼%黄燕
張宇輝%張健%卿恩明%黎輝%孫英賢%張麟%白小涓%劉文嫻%薑一農%麯鵬%韋丙奇%週瓊%黃燕
장우휘%장건%경은명%려휘%손영현%장린%백소연%류문한%강일농%곡붕%위병기%주경%황연
心力衰竭,充血性%左西孟旦%多巴酚丁胺
心力衰竭,充血性%左西孟旦%多巴酚丁胺
심력쇠갈,충혈성%좌서맹단%다파분정알
Heart failure,congestive%Levosimendan%Dobutamine
目的 研究探讨国产左西孟旦注射液治疗急性失代偿性心力衰竭(acute decompensated heart failure,ADHF)的安全性和有效性评价.方法 采用多中心、随机、盲法、阳性药物对照方法.入选ADHF患者并随机分入左西孟旦组和多巴酚丁胺组,分别静脉滴注24 h.结果 共入选8个参加医院的228例ADHF患者,左西孟旦组和多巴酚丁胺组各114例,其中接受SwanGanz导管检查并达到评价指标者[肺毛细血管楔压(PCWP)≥15 mm Hg(1 mm Hg=0.133 kPa)、心脏指数≤2.5 L·min-1·m-2]进行有创血液动力学监测,每组各39例.治疗24 h后,左西孟旦组左室射血分数(LVEF)较基线显著升高[(31.56±9.69)％与(28.44 ±7.08)％,P＜0.01],LVEF相对于基线变化值在两组间差异无统计学意义[(3.11±6.90)％与(3.00±6.63)％,P ＞0.05].治疗24 h后,左西孟旦组PCWP相对于基线下降值较多巴酚丁胺组差异有统计学意义[(-8.90 ±7.14)mm Hg与(-5.64 ±6.83)mm Hg,P=0.04].用药3d后,血浆N末端B型利钠肽原较基线变化率在左西孟旦组显著大于多巴酚丁胺组[(- 22.36±38.98)％与(- 8.56±42.42)％,P＜0.01].用药后24 h,左西孟旦组呼吸困难改善较多巴酚丁胺组显著.结论 国产左西孟旦对ADHF患者提高LVEF的作用与多巴酚丁胺差异无统计学意义,更显著降低PCWP和N末端B型利钠肽原水平,改善症状,耐受性和安全性良好.
目的 研究探討國產左西孟旦註射液治療急性失代償性心力衰竭(acute decompensated heart failure,ADHF)的安全性和有效性評價.方法 採用多中心、隨機、盲法、暘性藥物對照方法.入選ADHF患者併隨機分入左西孟旦組和多巴酚丁胺組,分彆靜脈滴註24 h.結果 共入選8箇參加醫院的228例ADHF患者,左西孟旦組和多巴酚丁胺組各114例,其中接受SwanGanz導管檢查併達到評價指標者[肺毛細血管楔壓(PCWP)≥15 mm Hg(1 mm Hg=0.133 kPa)、心髒指數≤2.5 L·min-1·m-2]進行有創血液動力學鑑測,每組各39例.治療24 h後,左西孟旦組左室射血分數(LVEF)較基線顯著升高[(31.56±9.69)％與(28.44 ±7.08)％,P＜0.01],LVEF相對于基線變化值在兩組間差異無統計學意義[(3.11±6.90)％與(3.00±6.63)％,P ＞0.05].治療24 h後,左西孟旦組PCWP相對于基線下降值較多巴酚丁胺組差異有統計學意義[(-8.90 ±7.14)mm Hg與(-5.64 ±6.83)mm Hg,P=0.04].用藥3d後,血漿N末耑B型利鈉肽原較基線變化率在左西孟旦組顯著大于多巴酚丁胺組[(- 22.36±38.98)％與(- 8.56±42.42)％,P＜0.01].用藥後24 h,左西孟旦組呼吸睏難改善較多巴酚丁胺組顯著.結論 國產左西孟旦對ADHF患者提高LVEF的作用與多巴酚丁胺差異無統計學意義,更顯著降低PCWP和N末耑B型利鈉肽原水平,改善癥狀,耐受性和安全性良好.
목적 연구탐토국산좌서맹단주사액치료급성실대상성심력쇠갈(acute decompensated heart failure,ADHF)적안전성화유효성평개.방법 채용다중심、수궤、맹법、양성약물대조방법.입선ADHF환자병수궤분입좌서맹단조화다파분정알조,분별정맥적주24 h.결과 공입선8개삼가의원적228례ADHF환자,좌서맹단조화다파분정알조각114례,기중접수SwanGanz도관검사병체도평개지표자[폐모세혈관설압(PCWP)≥15 mm Hg(1 mm Hg=0.133 kPa)、심장지수≤2.5 L·min-1·m-2]진행유창혈액동역학감측,매조각39례.치료24 h후,좌서맹단조좌실사혈분수(LVEF)교기선현저승고[(31.56±9.69)％여(28.44 ±7.08)％,P＜0.01],LVEF상대우기선변화치재량조간차이무통계학의의[(3.11±6.90)％여(3.00±6.63)％,P ＞0.05].치료24 h후,좌서맹단조PCWP상대우기선하강치교다파분정알조차이유통계학의의[(-8.90 ±7.14)mm Hg여(-5.64 ±6.83)mm Hg,P=0.04].용약3d후,혈장N말단B형리납태원교기선변화솔재좌서맹단조현저대우다파분정알조[(- 22.36±38.98)％여(- 8.56±42.42)％,P＜0.01].용약후24 h,좌서맹단조호흡곤난개선교다파분정알조현저.결론 국산좌서맹단대ADHF환자제고LVEF적작용여다파분정알차이무통계학의의,경현저강저PCWP화N말단B형리납태원수평,개선증상,내수성화안전성량호.
Objective To compare the efficacy and safety of domestic levosimendan versus dobutamine for patients with acute decompensated heart failure (ADHF).Methods ADHF patients from 8 medical centers were recruited in this multicenter,blind,positive-controlled,randomized study and received 24 h intravenous levosimendan (n =114) or dobutamine (n =114) therapy.SWAN-GANZ catheter was performed in patients with pulmonary capillary wedge pressure (PCWP) ≥ 15 mm Hg ( 1 mm Hg =0.133kPa) and cardiac index (CI) ≤ 2.5 L · min-1 · m-2 ( n =39 each).Results Compared with baseline level,LVEFincreased [(31.56 ±9.69)％ vs.(28.44 ±7.08)％,P＜0.01] at 24 h in both groups.LVEF increase at 24 h was similar between two groups [ ( 3.11 ± 6.90 ) ％ vs.( 3.00 ± 6.63 ) ％,P ＞0.05].The PCWP decrease at 24 h was significantly greater in levosimendan group than in dobutamine group [ ( - 8.90 ± 7.14) mm Hg vs.( - 5.64 ± 6.83) mm Hg,P =0.04 ].Decrease in NT-proBNP at 3 days was also more significant in levosimendan group than in dobutamine group [ the percentage change compared to baseline:( - 22.36 ± 38.98) ％ vs.( - 8.56 ± 42.42) ％,P ＜ 0.01 ].Dyspnea improvement at 24 h was more significant in levosimendan group than in dobutamine group.The incidences of adverse reactions and events were similar between two groups.Conclusion LVEF improvement is similar between dobutamine and domestic levosimendan while greater decreases in PCWP and NT-proBNP are achieved with domestic levosimendan in patients with ADHF.
