左西孟旦治疗重度心力衰竭疗效观察.docVIP

左西孟旦治疗重度心力衰竭疗效观察 　　【摘要】目的 评价对常用强心药物治疗疗效不佳的重度心力衰竭患者，静脉注射左西孟旦的有效性及安全性。方法 选取2015年6月～2016年5月我科收治的心力衰竭患者20例作为研究对象，左西孟旦注射液以0.1 μg（kg?min）静脉泵入，1 h后增加到0.2 μg（kg?min）并持续23 h。观察治疗前、治疗24 h 后的总有效率、左心室射血分数（LVEF）及其他重要实验室检查，综合评价药物的疗效和安全性。结果 治疗24 h后，疗效理想；主要表现为LVEF提高17.75%；患者临床生命体征及实验室检查结果显著改善。患者药物不良反应发生率为20%，常见的不良反应为低血压及室性早搏。结论 左西孟旦注射液治疗重度心力衰竭早期的疗效确切，安全性高，患者耐受性好。 　　【关键词】左西孟旦；重度心力衰竭；心功能 　　【中图分类号】R541.6 【文献标识码】A 【文章编号】ISSN.2095-6681.2016.24.00.02 　　Curative effect observation of leosimendan treatment of 　　severe heart failure 　　PENG Bo，LU Ying-ying*，WU Jun，LV Ying 　　（Beijing fengtai hospital（south bridge）intensive medicine，Beijing 100070，China） 　　【Abstract】Objective To evaluate the efficacy and safety of intravenous injection of Levosimendan in patients with severe heart failure after conventional drug therapy.Methods For 20 patients with heart failure， intravenous pump into Levosimendan injection by 0.1ug/kg/min and then increase to 0.2ug/kg/min after 1hr， and continued for 23 hrs. Clinical efficacy， left ventricular ejection fraction（LVEF）and other key laboratory tests were observed before and after treatment for 24 h， and the efficacy and safety of the drug were evaluated comprehensively.Results Clinical results were satisfactory after 24hrs treatment. The main results were as following： the left ventricular ejection fraction（LVEF）increased by 17.75%. The clinical signs and laboratory findings of the patients were significantly improved. The incidence of adverse drug reactions was 20%. The most common adverse reactions were hypotension and ventricular premature beats.Conclusion The early efficacy of Levosimendan Injection in the treatment of patients with severe heart failure is clear and safe. Patients were well tolerated. 　　【Key words】Levosimendan；Severe heart failure；Cardiac function 　　随着社会人口老龄化的发展，老年人已经成为心力衰竭的主要发病群体，心力衰竭也逐渐成为老年患者主要死亡原因之一。不论何种病因，心力衰竭患者预后都很差。在急性加重的严重心力衰竭的患者中，第一年死亡率大约40% [1]。5年存活率不足50%[2]。目前，临床治疗心力衰竭的主要药物包括正性肌力药、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂、β受体阻滞剂及磷酸二酯酶抑制剂。临床