左西孟旦治疗高龄顽固性心力衰竭的疗效

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摘要目的观察左西孟旦(levosimendan) 小剂量静脉维持治疗老年顽固性心力衰竭的疗效。方法心力衰竭36例,均为使用常规抗心力衰竭治疗效果欠佳者,给予左西孟旦小剂量持续静脉滴注(0.05~0.2)μg/(kg·min),观察使用左西孟旦的治疗效果及过程中出现的不良反应。结果 36例共46次使用左西孟旦,部分患者间断重复使用。经左西孟旦治疗72 h后,患者血管收缩压(systolic blood pressure, SBP)、血管舒张压(diastolic blood pressure, DBP)及心率(heart rate, HR)均较治疗前有所降低,无统计学差异(P>0.05);N-末端脑钠肽前体(N-terminal pro-type natriuretic peptide, NT-proBNP)较治疗前显著降低(11785.22±10903.34 vs 5989.83±6044.02);左室射血分数(left ventricular ejection fraction, LVEF)、每博心输出量(stroke volume, SV)均较治疗前显著升高(35.11±4.21 vs 50.09±9.37)、(37.22±17.26 vs 69.90±34.62),差异均有统计学意义(P<0.05)。血肌酐(Cr)数值较治疗前有所降低(216.03±32.75 vs 137.43±29.07),无统计学差异(P>0.05);尿排出量与治疗前相比显著增多(1383.57±431.14 vs 1906.72±522.70),差异有统计学意义(P<0.05)。结论左西孟旦治疗老年顽固性心力衰竭患者疗效非常明显,可显著提高患者心脏功能及肾脏功能。

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	刘旭
	薛婧
	王楠
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关键词 ：顽固性心力衰竭, 左西孟旦, 肾功能不全

Abstract：Objective To observe the clinical effect of levosimendan for treatment of refractory heart failure and mild renal dysfunction.Methods There were 36 heart failure patients on whom conventional heart failure therapies had poor effects. Each of these patients was given the continuous intravenous drip of levosimendan (0.05~0.2 μg/kg/min, according to the directions ) to observe the effects and side effects.Results The 36 patients used levosimendan for a total of 46 times, but some of these patients took this medicine on and off. After 72 hours of treatment, levels of NT-proBNP were significantly different(11785.22±10903.34 vs 5989.83±6044.02, P<0.05 ). LVEF and SV improved significantly in levosimendan group after treatment(35.11±4.21 vs 50.09±9.37; 37.22±17.26 vs 69.90±34.62, P<0.05). After treatment, the level of Cr showed no significant difference(716.02±342.75 vs 137.43±79.07, P>0.05), but the volume of urine was increased significantly(1383.57±431.14 vs 1906.72±522.70, P<0.05).ConclusionsLevosimendan can further improve heart function in patients with refractory heart failure.

Key words： refractory heart failure levosimendan mild renal dysfunction

收稿日期: 2018-01-25

ZTFLH:

R541.6

作者简介: 刘旭,主管药师,博士研究生。

引用本文:

刘旭,薛婧,王楠,刘洋. 左西孟旦治疗高龄顽固性心力衰竭的疗效[J]. 武警医学, 2018, 29(4): 336-340. LIU Xu, XUE Jing, WANG Nan, LIU Yang. Clinical Effect of levosimendan in the treatment of refractory heart failure in senile patients. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(4): 336-340.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2018/V29/I4/336

[1]	陆再英,钟南山,内科学[M].7版.北京:人民卫生出版社,2008.179.
[2]	Rich M W. Heart failure in the 21st century:a cardiogeriatric syndrome[J]. Gerontol A Biol Sci Med Sci,2001,56(2):M88-96.
[3]	Curtis L H,Whellan D J,Hammill B G, et al. Incidence and prevalence of heart failure in elderly persons,1994-2003[J].Arch Intern Med,2008,168(4):418-424.
[4]	Holzem K M,Efimov I R. Arrhythmogenic remodelling of activation and repolarization in the failing human heart[J].Europace,2012,14(5):50-57.
[5]	Ramani G V, Uber P A, Mehra M R. Chronic heart failure:contemporary diagnosis and management[J].Mayo Clin Proc,2010,85(2):180-195.
[6]	Rohde L E,Bertoldi E G,Goldraich L,et al. Cost- effectiveness of heart failure therapies[J]. Nat Rev Cardiol,2013, 10(6):338-341
[7]	McMurray J J,Adamopoulos S,Anker S D,et al. ESC Committee for Practice Guidelines. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association ( HFA) of the ESC[J]. Eur Heart J,2012,33(14) : 1787-1790
[8]	Lee J A, Allen D G. Calcium sensitisers[J].BMJ,1990,300(6724):551-552.
[9]	余星燕. 左西孟旦治疗心衰的临床研究进展[C]//全国第十三届心脏学会、第十六届心功能学会《心脏杂志》编委会联合学术会议论文集,2013:739-741,745.
[10]	中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 慢性心力衰竭诊断治疗指南[J]. 中华心血管病杂志,2014:42( 2):1.
[11]	Nieminen M S,Altenberger J,Ben- Gal T. Repetitive use of levosimendan for treatment of chronic advanced heart failure: Clinical evidence,practical considerations,and perspectives: An expert panel consensusInt[J]. J Cardiol, 2014,174(2):360-363.
[12]	Mehmet B, etal. Renal effects of levosimendan:a consensus report[J]. Cardiovasc Drugs Ther,2013,27(6):581-590.
[13]	余星燕. 左西孟旦治疗老年顽固性心力衰竭临床疗效及安全性分析[D].延安:延安大学,2014:1-49
[14]	NG T M. Levosimendan, a new calcium sensitizing inotropoe for heart failure [J].Pharmacotherapy, 2004, 24(10):1366-1384.
[15]	中华医学会心血管病学分会,中华心血管杂志编辑委员会.急性心力衰竭诊断和治疗指南[J].中华心血管病杂志,2010,38(3):195-199
[16]	Vasan R S, Larson M G, Benjamin E J, et al. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction[J]. J Am Coll Cardiol, 1999,33:1948-1955.
[17]	McMurray J J,Adamopoulos S,Anker S D, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012:The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association(HFA)of the ESC[J].Eur Heart J,2012, 33(14):1787-1847.
[18]	Januzzi J L. The role of natriuretic peptide testing in guiding chronic heart failure management:review of available data and recommendations for use[J].Arch Cardiovasc Dis,2012,25105(1):40-50.
[19]	Mebazaa A,Nieminen M S,Packer M,et al. Levosimendan vs dobutamine for patients with acute decompensated heart failure:the SURVIVE randomized Trial[J]. JAMA,2007,297(17):1883-89.
[20]	Packer M,Colucci W,Fisher L,et al. Effect of levosimendan on the short-term clinical course of patients with acutely decompensated heart failure[J]. JCHF, 2013,1(2):103-109.