左西孟旦联合前列地尔治疗慢性心力衰竭伴肺动脉高压疗效观察.docVIP

左西孟旦联合前列地尔治疗慢性心力衰竭伴肺动脉高压疗效观察 　　摘要：目的 观察左西孟旦联合前列地尔治疗慢性心力衰竭伴肺动脉高压患者的疗效。方法 选取我院2015年10月～2016年12月心血管内科收治的慢性心力衰竭PH患者60例，将其随机分为治疗组30例和对照组30例。对照组给予常规药物治疗，治疗组在常规药物治疗基础上给予左西孟旦联合前列地尔治疗，观察两组患者治疗前后肺动脉压、左室射血分数（LVEF）、N末端B型利纳肽原（NT-pro-BNP）变化。结果 两组患者治疗前后肺动脉压、NT-pro-BNP均降低，LVEF均增加，差异有统计学意义（P0.05）。结论 左西孟旦联合前列地尔治疗慢性心力衰竭伴肺动脉高压患者，可增强其心肌收缩力，提高LVEF，改善心功能、pH，疗效显著，值得临床应用。 　　关键词：慢性心力衰竭；肺动脉高压；左西孟旦；前列地尔 　　中图分类号：R541.6；R544.1 文献标识码：A 文章编号：1006-1959（2017）20-0085-02 　　Abstract：Objective To observe the efficacy of levosimendan combined with alprostadil in the treatment of chronic heart failure with pulmonary hypertension.Methods 60 patients with chronic heart failure PH in our hospital from October 2015～December 2016 were cardiovascular patients， which were randomly divided into treatment group of 30 cases and 30 cases in the control group.The control group received conventional therapy， treatment group was treated with levosimendan combined with alprostadil therapy based on routine treatment，observe two groups of patients before and after treatment pulmonary artery pressure，left ventricular ejection fraction（LVEF），N terminal B type natriuretic peptide（NT-pro-BNP）changes the original.Results Two groups of patients before and after treatment of pulmonary artery pressure，NT-pro-BNP decreased，LVEF increased，the difference was statistically significant（P0.05）.Conclusion Levosimendan combined with alprostadil in the treatment of patients with pulmonary hypertension in chronic heart failure，which can enhance myocardial contractility，improve LVEF，improve heart function，pH，significant effect，worthy of clinical application. 　　Key words：Chronic heart failure；Pulmonary hypertension；Levosimendan；Alprostadil 　　充血性心衰是由于心?K结构或功能性疾病导致心室充盈和射血功能障碍，心排血量不能满足机体的需要，以肺循环或体循环淤血，器官、组织灌注不足为临床表现[1]。伴肺动脉高压时，右心负荷增大，右心功能下降，迅速进展为全心衰，使运动耐量降低，致死率均较高[2]。左西孟旦是一种新型的Ca2+增敏剂，多项临床试验证明对心衰治疗效果确切，前列地尔主要的生理作用包括扩张肺动脉在内的血管平滑肌，前列地尔能抑制缩血管物质的合成，抑制神经末稍释放去甲肾上腺素，舒张血管平滑肌细胞，进而扩张血管床，由于代谢前列地尔的酶主要分布在肺部、肝、肾等部位，因此前列地尔对肺血管的扩张尤为明显。因此理论上左西孟旦和前列地尔联合应用