CAJ | 학술논문

目的：探讨左西孟旦对高龄老年人左心衰的临床疗效及安全性。方法选择2014年9月至2015年4月在解放军总医院心内科确诊为慢性左心衰住院的高龄老年患者58例，男21例，女37例，年龄为（86.8±1.5）岁。进行自身前后对比研究，分别在应用左西孟旦治疗前、治疗后3d、治疗后3个月进行血清B型利钠肽（BNP）、左室射血分数（LVEF）、左室短轴缩短率（LVFS）、6min步行试验（6MWT）等指标检测。结果治疗后3d的血BNP值明显低于治疗前（P＜0.01）；治疗后3d的LVEF，LVFS，6MWT明显优于治疗前（P＜0.01）；治疗后3个月的血BNP值明显低于治疗前（P＜0.01）；治疗后3个月的LVEF，LVFS，6MWT明显高于治疗前（P＜0.01）；治疗前、治疗后3d、治疗后3个月的肝功：丙氨酸氨基转移酶（ALT），天冬氨酸氨基转移酶（AST），谷氨酰胺转移酶（γ-GT），肾功：血肌酐（SCr），血尿素氮（BUN），血尿酸（SUA），均无明显改变（P＞0.05）；治疗前后血压值也无显著变化（P＞0.05）。结论单次给药左西孟旦对高龄老年心力衰竭患者有疗效且安全可靠。
목적：탐토좌서맹단대고령노년인좌심쇠적림상료효급안전성。방법선택2014년9월지2015년4월재해방군총의원심내과학진위만성좌심쇠주원적고령노년환자58례，남21례，녀37례，년령위（86.8±1.5）세。진행자신전후대비연구，분별재응용좌서맹단치료전、치료후3d、치료후3개월진행혈청B형리납태（BNP）、좌실사혈분수（LVEF）、좌실단축축단솔（LVFS）、6min보행시험（6MWT）등지표검측。결과치료후3d적혈BNP치명현저우치료전（P＜0.01）；치료후3d적LVEF，LVFS，6MWT명현우우치료전（P＜0.01）；치료후3개월적혈BNP치명현저우치료전（P＜0.01）；치료후3개월적LVEF，LVFS，6MWT명현고우치료전（P＜0.01）；치료전、치료후3d、치료후3개월적간공：병안산안기전이매（ALT），천동안산안기전이매（AST），곡안선알전이매（γ-GT），신공：혈기항（SCr），혈뇨소담（BUN），혈뇨산（SUA），균무명현개변（P＞0.05）；치료전후혈압치야무현저변화（P＞0.05）。결론단차급약좌서맹단대고령노년심력쇠갈환자유료효차안전가고。
ObjectiveTodetermine the clinical efficacy and safety oflevosimendanforthe veryelderly patientswithleft heart failure.Methods A total of 58 very elderly patients[age:(86.8±1.5) years, 21 males and 37 females]with chronic left heart failure admitted inourdepartmentfrom September 2014 to April 2015 wereprospectively recruited in this study.A self-controlled trial was carried out on the efficacy oflevosimendan.Serum B-type natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), left ventricularfractional shortening (LVFS),and6-minute walking test (6MWT)were measuredbefore and in 3 d and 3 months after treatment.Results In 3d afterlevosimendan treatment, their serum levels of BNP was significantly decreased, and the values of LVEF,LVFS and 6MWT were much better than before treatment (allP<0.01). After 3 months’ treatment, the BNP level was obviously lower, and the values of LVEF,LVFS and 6MWT were greatly improved than those before treatment (allP<0.01). There was no significant difference inblood pressure values,liver function parameters [alanine aminotransferase (ALT), aspartate aminotransferase (AST),andγ-transglutaminase (γ-GT)],and renal function indices [serum creatinine (SCr), blood urea nitrogen (BUN),andserum uric acid (SUA)] in the cohort before and in 3d and 3 monthsaftertreatment(P>0.05).ConclusionSingle dose levosimendan is efficient and safe inthe treatment of heartfailure for the veryelderly.