左西孟旦治疗老年急慢性重度心力衰竭患者的疗效分析

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1、左西孟旦治疗老年急慢性重度心力衰竭患者的疗效分析作者单位：425000湖南省永州市第三人民医院通讯作者：夏徳武【摘要】目的评价左酋孟旦注射液对•常规治疗疗效不佳的老年急、慢性重度心力衰竭患者的有效性及安全性。方法采用随机、平行对照临床研究。入选老年急、慢性重度心力衰竭患者随机分成两纟R。试验纟R71例，对照纽.70例，分别接受左術孟旦和多巴酚丁胺治疗，综介评价药物的疗效和安全性。结果试验组临床冇效率为32.4%(23/71),对照组临床冇效率为17.1%(12/70)(PV0.01)；治疗24h后试验

2、组和对照组的左心室射血分数(LVEF)±升均值分别为6.2%和4.5%(P>0.05)；治疗24h后试验组与对照组每博心输出量(SV)上升均值分别为11.8ml和3.2ml(P<0.05)；试验组患者呼吸困难和全身临床状况显著改善。两组均未发工严重不良事件，试验组不良反应发牛率显著低于对照组(PV0.05),常见的不良反应为低血钾、低血压以及室性早搏等。结论与多巴酚丁胺相比，左西孟旦注射液治疗老年急、慢性重度心力衰蝎疗效确切，安全性及患者耐受性良好。【关键词】老年患者；重度心力衰竭；左西孟旦；治疗结果

3、EfficacyofintravenouslevosimendanfortheagedacuteandchronicsevereheartfailureXIADe-wu,SHENGMao-di.TheThirdPeople'sHospitalofYongzhouCity,Yongzhou42500,Hunan,China[Abstract]ObjectiveTocomparetheefficacyandsafetyofintravenouslevosimendaninpatientswiththeag

4、edacuteandchronicsevereheartfailuretotheconventionalmedication.Methodspatientswererecuitedintothisrandomizedandparalled-groupstudytoreceivetitherlevosimendanordobutamninetherapyinpatientswiththeagedacuteandchronicsevereheartfailure.Inthetestgroup,aninit

5、ialloadingdoseoflevsimendanof12ug/kgwasinfusedover10min,followedbyacontinuousinfusionof0.05-0・1ug/(kg•min)forfor24h.Inthecontrolgroup,dobutaminewasinfusedfor1hataninitialdoseof2ng/(kg•min)withoutaloadingdose,followedbyacontinuousinfusionof4yg/(kg•min)fo

6、r23h,Clinicalassessmentwasperformedtoevaluateefficacyandsafetyofthemedications・ResultsAtatalof141patientswereevaluate;71assignedtolevosimendanand70assignedtodobutaminegroup.Theeffectivenessratewas32.4%(23/71)inthelevosimendangroupand17.1%(12/70)inthedob

7、utaminegroup(P<0.01);At24h,leftventricaularejectionfraction(LVEF)wasimprovedby6.2%inthelevosimendangroup,comparedwith4.5%inthedobutaminegroup(P>0.05);Stokevolume(SV)wasincreaseby11.8mlinthelevosimendangroupand3.2mlinthedobutaminegrouprespectively(PV0.05

8、);Dyspneaandclinicmanifestationsimprovementsimprovementsweremoresignificantinlevosimendantherapygroupcomparedtodobutaminegroup.Therewerethelessadverseeffectsincludinghypokalemia,hypotensionandventricularprematurebeatsinthelevosim