中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
15期
7-9
,共3页
心力衰竭%左西孟旦%N 末端-脑钠肽前体%乳酸清除率
心力衰竭%左西孟旦%N 末耑-腦鈉肽前體%乳痠清除率
심력쇠갈%좌서맹단%N 말단-뇌납태전체%유산청제솔
Heart failure%Levosimendan%N-terminal-brain natriuretic peptide%Lactate clear-ance rate
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、30 d 住院例数均少于对照组（P ﹤0.05），两组出院后30 d 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。
目的：探討左西孟旦對難治性心力衰竭患者血 N 末耑-腦鈉肽前體（NT-proBNP）和乳痠清除率的影響。方法將86例難治性心力衰竭患者按照數字錶法隨機分為對照組和觀察組，每組43例，對照組採用基礎治療加米力農，觀察組採用基礎治療加左西孟旦。測定患者每搏輸齣量（SV）、心輸齣量（CO）、心髒指數（CI）、左室射血分數（LVEF）及左室舒張末期內徑（LVDD）。治療前後測定血 NT-proBNP 和乳痠清除率。結果兩組治療後SV、CO、CI、LVEF 及 LVDD 均有明顯改善，併且治療後觀察組 SV、CO、CI、LVEF 改善更明顯（P ﹤0.05），兩組治療後LVDD 比較差異無統計學意義（P ﹥0.05）。觀察組住院天數、30 d 住院例數均少于對照組（P ﹤0.05），兩組齣院後30 d 全因死亡例數比較差異無統計學意義（P ﹥0.05）。對照組總有效率為81.4%，觀察組為93.0%，兩組比較差異有統計學意義（P ﹤0.05）。兩組血漿 NT-proBNP 治療後均明顯降低，併且觀察組降低更明顯（P ﹤0.05），觀察組治療後乳痠清除率明顯高于對照組（P ﹤0.05）。結論左西孟旦可以明顯降低難治性心力衰竭患者血 NT-proBNP和提高乳痠清除率。
목적：탐토좌서맹단대난치성심력쇠갈환자혈 N 말단-뇌납태전체（NT-proBNP）화유산청제솔적영향。방법장86례난치성심력쇠갈환자안조수자표법수궤분위대조조화관찰조，매조43례，대조조채용기출치료가미력농，관찰조채용기출치료가좌서맹단。측정환자매박수출량（SV）、심수출량（CO）、심장지수（CI）、좌실사혈분수（LVEF）급좌실서장말기내경（LVDD）。치료전후측정혈 NT-proBNP 화유산청제솔。결과량조치료후SV、CO、CI、LVEF 급 LVDD 균유명현개선，병차치료후관찰조 SV、CO、CI、LVEF 개선경명현（P ﹤0.05），량조치료후LVDD 비교차이무통계학의의（P ﹥0.05）。관찰조주원천수、30 d 주원례수균소우대조조（P ﹤0.05），량조출원후30 d 전인사망례수비교차이무통계학의의（P ﹥0.05）。대조조총유효솔위81.4%，관찰조위93.0%，량조비교차이유통계학의의（P ﹤0.05）。량조혈장 NT-proBNP 치료후균명현강저，병차관찰조강저경명현（P ﹤0.05），관찰조치료후유산청제솔명현고우대조조（P ﹤0.05）。결론좌서맹단가이명현강저난치성심력쇠갈환자혈 NT-proBNP화제고유산청제솔。
Objective To study the effect of levosimendan on N-terminal-brain natriuretic pep-tide(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 treat-ment,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 ﹤ 0. 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 observa-tion 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.
