2021 年第 4 期 第 16 卷

左西孟旦注射液治疗急性心肌梗死后心力衰竭患者的效果及对心功能的影响

Curative effect of levosimendan injection on heart failure in patients after acute myocardial infarction and its influence on cardiac function

作者：张媛王欣刘佳孙昊郭宗生刘佳梅陈牧雷

英文作者：Zhang Yuan Wang Xin Liu Jia Sun Hao Guo Zongsheng Liu Jiamei Chen Mulei

单位：首都医科大学附属北京朝阳医院心脏中心高血压病研究北京市重点实验室100020

英文单位：Heart Center Beijing Chaoyang Hospital Capital Medical University Beijing Key Laboratory of Hypertension Beijing 100020 China

关键词：急性心肌梗死；心力衰竭；左西孟旦

英文关键词：Acutemyocardialinfarction;Heartfailure;Levosimendan

• 摘要：

• 目的 观察左西孟旦注射液治疗急性心肌梗死后心力衰竭患者的效果及对心功能的影响。方法 选取2018年1月至2020年10月首都医科大学附属北京朝阳医院心脏中心收治的119例急性心肌梗死后心力衰竭患者，按照随机数字表法分为观察组（63例）和对照组（56例）。对照组给予标准的冠心病(冠状动脉粥样硬化性心脏病)二级预防及抗心力衰竭治疗，观察组在对照组的基础上加用左西孟旦注射液治疗。比较2组治疗效果、心功能指标、用药安全性、院内死亡率及平均住院时间。结果 治疗后，观察组总有效率明显高于对照组［84.1%（53/63）比67.9%（38/56）］，差异有统计学意义(P＜0.05)。观察组治疗后B型脑钠肽水平明显低于治疗前和对照组，左心室射血分数水平明显高于治疗前，差异均有统计学意义（均P＜0.05）。治疗期间，2组药物不良反应发生率比较，差异无统计学意义(P＞0.05)。观察组院内死亡率及平均住院时间均明显低于/短于对照组，差异均有统计学意义(均P＜0.05)。结论 左西孟旦治疗急性心肌梗死后心力衰竭患者的临床效果较好，可以有效改善患者的心功能指标，降低患者的院内死亡率并缩短平均住院时间。

• Objective  To investigate the curative effect of levosimendan injection on heart failure in patients after acute myocardial infarction and its influence on cardiac function. Methods From January 2018 to October 2020, 119 patients with heart failure after acute myocardial infarction admitted to the Heart Center, Beijing Chaoyang Hospital, Capital Medical University were enrolled. They were randomly divided into observation group (63 cases) and control group (56 cases). The control group was given standard secondary prevention of coronary atherosclerotic heart disease and anti heart failure treatment, and the observation group was given levosimendan injection on the basis of the control group. The curative effect, cardiac function indexes, medication safety, hospital mortality and average length of stay were compared between the two groups. Results After treatment, the total effective rate of the observation group was significantly higher than that of the control group［84.1%(53/63) vs 67.9%(38/56)］(P＜0.05). The brain natriuretic peptide level of the observation group after treatment was significantly lower than that before treatment and that of the control group, and the left ventricular ejection fraction level of the observation group was significantly higher than that before treatment (all P＜0.05). During the treatment, there was no significant difference in the incidence of adverse drug reactions between the two groups (P＞0.05). The hospital mortality and average length of stay of the observation group were significantly lower/shorter than those of the control group, and the differences were statistically significant (all P＜0.05). Conclusions  Levosimendan has significant clinical effect on the treatment of heart failure in patients after acute myocardial infarction. It can effectively improve the cardiac function indexes of patients, and reduce the hospital mortality and average length of stay of patients.