CAJ | 학술논문

目的研究新型钙离子增敏剂左西孟旦在充血性心力衰竭治疗中的应用.方法选取2012年1月至2013年9月医院收治的充血性心力衰竭患者172例,按随机数字表法分为治疗组和对照组,各86例.对照组患者给予强心剂(洋地黄、多巴胺)、利尿剂、扩张血管药物、血管紧张素转化酶抑制剂(ACEI)类药物治疗,治疗组患者在此基础上加用左西孟旦.结果治疗后,治疗组呼吸困难总改善率为95. 35%,明显高于对照组的77. 91%( P<0. 05);治疗后72 h,治疗组心功能分级改善有效率为90. 70%,明显高于对照组的70. 93%( P<0. 05);两组患者左室射血分数(LVEF)和左室短轴缩短率(FS)均较治疗前明显改善,且治疗组改善情况更优( P<0. 05);两组患者心率均较治疗前有所下降( P<0. 05),但组间无明显差异( P>0. 05);治疗组不良反应发生率为6. 98%,与对照组的8. 14%无明显差异( P>0. 05);随访3个月,治疗组再住院率为9. 30%,明显低于对照组的26. 74%( P<0. 05);治疗组死亡率为2. 33%,明显低于对照组的8. 14%( P<0. 05).结论左西孟旦治疗充血性心力衰竭,可改善呼吸困难、心功能分级情况及心脏超声心功能指标,对血流动力学影响小,不良反应较少,还能降低患者再住院率及死亡率,值得临床推广.
목적 연구신형개리자증민제좌서맹단재충혈성심력쇠갈치료중적응용.방법 선취2012년1월지2013년9월의원수치적충혈성심력쇠갈환자172례,안수궤수자표법분위치료조화대조조,각86례.대조조환자급여강심제(양지황、다파알)、이뇨제、확장혈관약물、혈관긴장소전화매억제제(ACEI)류약물치료,치료조환자재차기출상가용좌서맹단.결과 치료후,치료조호흡곤난총개선솔위95. 35%,명현고우대조조적77. 91%( P<0. 05);치료후72 h,치료조심공능분급개선유효솔위90. 70%,명현고우대조조적70. 93%( P<0. 05);량조환자좌실사혈분수(LVEF)화좌실단축축단솔(FS)균교치료전명현개선,차치료조개선정황경우( P<0. 05);량조환자심솔균교치료전유소하강( P<0. 05),단조간무명현차이( P>0. 05);치료조불량반응발생솔위6. 98%,여대조조적8. 14%무명현차이( P>0. 05);수방3개월,치료조재주원솔위9. 30%,명현저우대조조적26. 74%( P<0. 05);치료조사망솔위2. 33%,명현저우대조조적8. 14%( P<0. 05).결론 좌서맹단치료충혈성심력쇠갈,가개선호흡곤난、심공능분급정황급심장초성심공능지표,대혈류동역학영향소,불량반응교소,환능강저환자재주원솔급사망솔,치득림상추엄.
Objective To study the role of calcium sensitizer levosimendan used in the treatment of congestive heart failure. Methods 172 cases of patients with congestive heart failure in the hospital from January 2012 to September 2013 were divided into the treat-ment group and the control group according to the random number table, 86 cases in each group. The control group received anti-heart failure treatment with cardiac ( digitalis, dopamine ) , diuretics, drugs dilate blood vessels, ACEI drugs;the treatment group received treat-ment of levosimendan on the basis of the above medications. Results After treatment, the overall improvement in dyspnea of the obser-vation group was 95. 35%, which was significantly higher than 77. 91% of the control group ( P < 0. 05 );72 h after treatment, the ef-fective rate of cardiac function of the treatment group improved was 90. 70%, which was significantly higher than 70. 93% of the con-trol group ( P < 0. 05 );LVEF and FS of the two groups were significantly improved than before treatment ( P < 0. 05 ) , and the im-provement of the treatment group was better than the control group ( P < 0. 05 );the heart rate of the two groups decreased compared with before treatment ( P < 0. 05 ) , but there was no significant difference between the two groups ( P > 0. 05 );the occurrence rate of adverse reactions in the treatment group was 6. 98%, showing no significant difference with 8. 14% in the control group ( P > 0. 05 );in the 3 months follow-up, the readmission rate of the treatment group was 9. 30%, which was significantly lower than 26. 74% of the control group ( P < 0. 05 ); treatment group, the mortality rate was 2. 33%, significantly lower than the 8. 14% in the control group ( P < 0. 05 ) . Conclusion Levosimendan in the treatment of congestive heart failure can improve dyspnea, cardiac function and cardiac ultrasound situation cardiac function, with little influence on hemodynamics, fewer adverse reactions, can reduce patient readmission rates and mortality rate, which is worthy of clinical promotion.