摘要
目的:观察米力农注射液联合左西孟旦注射液治疗顽固性心力衰竭急性发作的临床疗效。方法:选择顽固性心力衰竭(按NYHA分级标准心功能Ⅲ～Ⅳ级)急性发作患者60例,随机分为对照组和治疗组,各30例。对照组予以常规西药治疗(地高辛、ACEI/ARB、醛固酮受体拮抗剂、利尿剂)+米力农注射液使用3d/周,连续4周;治疗组在此基础上第4天加用左西孟旦注射液,之后每周给药1次,连续4周。观察两组治疗前、治疗后心功能、NT-proBNP、外周静脉压(PVP)、6min步行实验(6MWT)变化及左室舒张末内径(LVDd)、左室射血分数(LVEF)变化。结果:治疗组心功能改善总有效率高于对照组(P <0. 05);治疗组PVP、NT-proBNP与对照组相比明显降低(P <0. 05);治疗组6MWT比对照组明显增加(P <0. 05);治疗组LVDd比对照组明显降低(P <0. 05);治疗组LVEF与对照组相比显著改善(P<0. 05)。两组不良反应发生率差异无统计学意义(P> 0. 05)。结论:米力农注射液联合左西孟旦注射液治疗顽固性心力衰竭急性发作期可显著改善患者临床症状,不同程度改善患者心功能和提高患者生活质量。
Objective:To observe the clinical efficacy of Milrinone Injection combined with Levosimendan Injection for the treatment of acute exacerbation of refractory heart failure.Methods:60patients with acute exacerbation of refractory heart failure(NYHA ClassⅢ~Ⅳ)were randomly assigned to the control group or test group each including30patients;the control group was treated with conventional western medicine(digoxin,ACEI/ARB,aldosterone receptor antagonist,diuretic)+Milrinone Injection3days a week continuously for4weeks;on this basis,Levosimendan Injection was added to the test group on treatment Day4,and thereafter administered once weekly continuously for4weeks.Both groups were observed for the changes in cardiac function,NT-proBNP,PVP and6-minute walk test(6MWT)pre-treatment and at4days of treatment,as well as the changes in left ventricular end-diastolic diameter(LVDd)and left ventricular ejection fraction(LVEF)at4weeks of treatment.Results:Compared to the control group,the overall response rate in terms of cardiac function improvement was significantly higher in the test group,indicating significantly better efficacy in the test group(P<0.05);NT-proBNP,Peripheral venous pressure(PVP)was significantly lower in the test group(P<0.05);and6MWT was significantly higher in the test group(P<0.05).Compared to the control group,LVDd was significantly lower in the test group(P<0.05);and LVEF was significantly improved in the test group(P<0.05).There was no significant difference between the test and control groups in the incidence of adverse reactions(P>0.05).Conclusion:Milrinone Injection combined with Levosimendan Injection could significantly improve the clinical symptoms of acute exacerbation of refractory heart failure,and improve the patient’s cardiac function and quality of life to varying extents.
作者
李广兵
丁丽
LI Guangbing;DING Li(Department of Cardiology the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei City,Anhui Province 230001)
出处
《医学理论与实践》
2018年第23期3485-3487,共3页
The Journal of Medical Theory and Practice
