药学实践杂志
藥學實踐雜誌
약학실천잡지
THE JOURNAL OF PHARMACEUTICAL PRACTICE
2014年
4期
297-299,314
,共4页
心力衰竭%难治性%左西孟旦%给药方法
心力衰竭%難治性%左西孟旦%給藥方法
심력쇠갈%난치성%좌서맹단%급약방법
refractory congestive heart failure (RCHF)%levosimendan%loading administration%non loading administration
目的：探讨左西孟旦负荷与非负荷给药方式的临床疗效。方法难治性心力衰竭患者40例，随机分为两组，每组20例，两组患者的基本情况、呼吸困难程度、左室射血分数（ EF）、脑钠肽（ BNP）水平无显著差异。两组均给予常规抗心力衰竭治疗；在此基础上随机给予左西孟旦负荷或非负荷治疗。左西孟旦负荷组：负荷剂量6～12μg/kg，负荷给药时间＞10 min，之后持续静脉输注0．1μg/（kg· min）；左西孟旦非负荷组：8．7μg/min速度匀速泵入，维持24 h。观察两组患者用药前后的呼吸困难程度、EF、BNP、血压、心率、心律、肝肾功能变化。并对过程中所有不良事件进行记录。结果用药后两组患者的呼吸困难程度、全身临床状况、BNP、EF值均较用药前改善，且两组治疗后BNP降低、EF值提高的程度无统计学差异。用药后30 min负荷组的呼吸困难好转程度优于非负荷组（P＝0．01），给药6、24、72 h后两组呼吸困难好转程度无明显差异。负荷组用药后30 min的收缩压及舒张压均低于非负荷组（P＝0．04和0．01），有统计学差异。结论左西孟旦能有效改善难治性心力衰竭患者的血流动力学和呼吸困难程度，降低BNP，提高EF值。左西孟旦非负荷给药与负荷给药治疗难治性心力衰竭的临床疗效相当，简便、安全、可靠。
目的：探討左西孟旦負荷與非負荷給藥方式的臨床療效。方法難治性心力衰竭患者40例，隨機分為兩組，每組20例，兩組患者的基本情況、呼吸睏難程度、左室射血分數（ EF）、腦鈉肽（ BNP）水平無顯著差異。兩組均給予常規抗心力衰竭治療；在此基礎上隨機給予左西孟旦負荷或非負荷治療。左西孟旦負荷組：負荷劑量6～12μg/kg，負荷給藥時間＞10 min，之後持續靜脈輸註0．1μg/（kg· min）；左西孟旦非負荷組：8．7μg/min速度勻速泵入，維持24 h。觀察兩組患者用藥前後的呼吸睏難程度、EF、BNP、血壓、心率、心律、肝腎功能變化。併對過程中所有不良事件進行記錄。結果用藥後兩組患者的呼吸睏難程度、全身臨床狀況、BNP、EF值均較用藥前改善，且兩組治療後BNP降低、EF值提高的程度無統計學差異。用藥後30 min負荷組的呼吸睏難好轉程度優于非負荷組（P＝0．01），給藥6、24、72 h後兩組呼吸睏難好轉程度無明顯差異。負荷組用藥後30 min的收縮壓及舒張壓均低于非負荷組（P＝0．04和0．01），有統計學差異。結論左西孟旦能有效改善難治性心力衰竭患者的血流動力學和呼吸睏難程度，降低BNP，提高EF值。左西孟旦非負荷給藥與負荷給藥治療難治性心力衰竭的臨床療效相噹，簡便、安全、可靠。
목적：탐토좌서맹단부하여비부하급약방식적림상료효。방법난치성심력쇠갈환자40례，수궤분위량조，매조20례，량조환자적기본정황、호흡곤난정도、좌실사혈분수（ EF）、뇌납태（ BNP）수평무현저차이。량조균급여상규항심력쇠갈치료；재차기출상수궤급여좌서맹단부하혹비부하치료。좌서맹단부하조：부하제량6～12μg/kg，부하급약시간＞10 min，지후지속정맥수주0．1μg/（kg· min）；좌서맹단비부하조：8．7μg/min속도균속빙입，유지24 h。관찰량조환자용약전후적호흡곤난정도、EF、BNP、혈압、심솔、심률、간신공능변화。병대과정중소유불량사건진행기록。결과용약후량조환자적호흡곤난정도、전신림상상황、BNP、EF치균교용약전개선，차량조치료후BNP강저、EF치제고적정도무통계학차이。용약후30 min부하조적호흡곤난호전정도우우비부하조（P＝0．01），급약6、24、72 h후량조호흡곤난호전정도무명현차이。부하조용약후30 min적수축압급서장압균저우비부하조（P＝0．04화0．01），유통계학차이。결론좌서맹단능유효개선난치성심력쇠갈환자적혈류동역학화호흡곤난정도，강저BNP，제고EF치。좌서맹단비부하급약여부하급약치료난치성심력쇠갈적림상료효상당，간편、안전、가고。
Objective To evaluate the efficacy of loading or non loading administration of levosimendan in the treatment of pa -tients with refractory congestive heart failure (RCHF).Methods A randomized, open, control clinical trial was conducted in 40 pa-tients with RCHF.Besides regular treatment , patients in test group ( n=20) were given levosimendan injection with initial loading dose of 6-12 μg/kg for 10 min,followed by a continuous infusion of 0.1 μg/(kg· min).While in control group (n=20), patients were given Levosimendan injection with a continuous infusion of 8.7μg/min for 24 h.Dyspnea, eject fraction(EF),BNP level, blood pressure, heart rate, rhythm of the heart, the function of liver and kidney before and after drug administration were examined .All ad-verse events during the process were recorded .Results The base line showed there was no significant difference between the 2 groups. Dyspnea degree , general clinical condition , BNP, EF values were all improved , compared with those in patients before treatment .Af-ter 30 min of administration, in test group improved dyspnea , decreased systolic and diastolic blood pressure were more greatly than those in control group (P=0.04 and 0.01, respectively).However there were no significant differences of dyspnea degree , decreased BNP, between the 2 groups after administration of 6 h, 24 h, and 72 h.In addition, there was no significant difference in enhanced EF value at 24 h, 72 h between the 2 groups.Conclusion Levosimendan was effective in treating RCHF and could improve hemodynam-ic, degree of dyspnea and decrease BNP , increase EF value.Compared with loading group, non loading administration of levosimendan in the treatment of RCHF was equivalent , safe, and more convenient .
