Efficacy Analysis of Levosimendan in the Treatment of Heart Failure Caused by Severe Coronary Heart Disease
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摘要:
目的 重症冠心病所致心衰患者在使用左西孟旦后的疗效及其安全性分析。 方法 选择2018年1月至2020年1月期间于昆明医科大学第一附属医院住院治疗的40例冠脉弥漫性病变重症患者，基于行左西孟旦干预与否，划分出对照组（n = 20）、实验组（n = 20）。两组对象入院后皆接受抗心力衰竭（HF）常规药物干预，实验组同时结合左西孟旦应用。对两组对象药物干预后心功能参数、不良反应、心肌酶学、肝肾功能、BNP进行收集分析。 结果 对经过相应治疗后的两组展开对比分析，发现实验组心功能参数增幅明显，且相比对照组（P < 0.05），即差异有统计学意义；另实验组BNP与心肌酶学参数皆明显偏低（P < 0.05）；在干预后肝肾功能水平上，对比两组结果为（P > 0.05），即未见明显区别；在治疗期间不良反应发生率方面，对比两组发现差异无统计学意义。 结论 左西孟旦的应用，可在一定程度上改善重症冠心病患者的心衰表现与心功能，且不会影响伤及肝肾功能，不良反应少，具备临床大量应用价值。 Abstract:Objective To analyze the efficacy and safety of levosimendan in patients with heart failure caused by severe coronary heart disease. Methods From January 2018 to January 2020, 40 patients who were hospitalized with the diffuse coronary artery disease were selected and divided into two groups according to the selection of levosimendan or not, with 20 cases in each group. Cardiac function index, myocardial enzymes, BNP, liver and kidney function changes and adverse reactions of the two groups were collected and analyzed. Results After the corresponding treatment, it was found that changes in cardiac function were statistically significant（P < 0.05）and differences in myocardial enzymes and BNP were statistically significant（P < 0.05）between the two groups. Also, there was no significant difference in liver and kidney function（P > 0.05）and the incidence of adverse reactions was not statistically significant（P > 0.05）. Conclusion The effect of levosimendan on severe coronary heart disease is obvious and the side effects of the drug are small. -
Key words:
- Severe coronary heart disease /
- Levosimendan /
- Heart failure
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表 1 两组间一般资料比较结果列表（
$\bar x\pm s$ ）Table 1. List of basic data comparison results（
$\bar x \pm s$ ）分组 n 年龄（岁） 体重（kg） 性别（n） 男 女 对照组 20 59.20 ± 3.10 65.50 ± 5.20 11 9 实验组 20 60.20 ± 2.30 67.60 ± 3.80 12 8 t/χ2 1.417 0.712 0.162 P 0.165 0.425 0.621 
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表 2 干预前后两组对象心功能对比结果（
$\bar x\pm s$ ）Table 2. Comparison of cardiac function between 2 groups before and after intervention（
$\bar x \pm s$ ）分组 时间 LVEF（%） LVESD（mm） 对照组（n = 20） 治疗前 36.59 ± 2.42 43.50 ± 1.25 治疗后 41.40 ± 2.45* 40.22 ± 1.70* 实验组（n = 20） 治疗前 36.50 ± 2.48 43.42 ± 1.20 治疗后 52.05 ± 2.58*△ 34.32 ± 1.50*△ t1/t2 7.49/4.79 5.43/4.23 P1/P2 0.01/0.04 0.02/0.04 注：t1、P1为时间统计值；t2、P2为组间因素统计值；与治疗前相比，*P < 0.05；与对照组相比，△P < 0.05；下同。
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表 3 干预前后两组研究对象心肌损伤对比结果（
$\bar x\pm s$ ）Table 3. Comparison results of myocardial injury between the 2 groups without intervention and after intervention（
$\bar x\pm s$ ）分组 时间 BNP（ng/L） CK-MB（U/L） cTnI（μg/L） 对照组（n = 20） 治疗前 2926.23 ± 298.33 87.03 ± 15.44 0.449 ± 0.150 治疗后 2566.44 ± 325.21* 50.46 ± 9.78* 0.399 ± 0.081* 实验组（n = 20） 治疗前 2918.45 ± 300.12 86.78 ± 15.89 0.442 ± 0.161 治疗后 1799.62 ± 192.43*△ 30.14 ± 5.12*△ 0.185 ± 0.054*△ t1/t2 6.14/7.59 6.07/5.45 5.12/4.43 P1/P2 0.01/ < 0.01 0.02/0.01 0.03/0.01
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表 4 干预前后两组研究对象肝肾功能对比结果（
$\bar x\pm s$ ）Table 4. The comparison results of liver and kidney function of the 2 groups before and after intervention are listed（
$\bar x\pm s$ ）分组 时间 肌酐（μmol/L） ALT（u/L） AST（u/L） 对照组（n = 20） 治疗前 82.43 ± 18.72 38.22 ± 4.21 39.56 ± 3.85 治疗后 81.89 ± 18.57 38.28 ± 4.19 39.91 ± 3.55 实验组（n = 20） 治疗前 83.11 ± 17.58 38.42 ± 4.20 39.65 ± 3.87 治疗后 81.78 ± 18.23 38.39 ± 4.15 39.89 ± 3.64 t1/t2 3.21/2.48 3.19/2.19 3.14/2.27 P1/P2 0.15/0.27 0.17/0.25 0.16/0.26
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