【摘要】 目的评价左西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组。试验组71例,对照组70例,分别接受左西孟旦和多巴酚丁胺治疗,综合评价药物的疗效和安全性。结果试验组临床有效率为32.4%(23/71),对照组临床有效率为17.1%(12/70)(P<0.01);治疗24 h后试验组和对照组的左心室射血分数(LVEF)上升均值分别为6.2%和4.5%(P>0.05);治疗24 h后试验组与对照组每博心输出量(SV)上升均值分别为11.8 m1和3.2 ml(P<0.05);试验组患者呼吸困难和全身临床状况显著改善。两组均未发生严重不良事件,试验组不良反应发生率显著低于对照组(P<0.05),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、慢性重度心力衰竭疗效确切,安全性及患者耐受性良好。更多还原

【Abstract】 Objective To compare the efficacy and safety of intravenous levosimendan in patients with the aged acute and chronic severe heart failure to the conventional medication.Methods patients were recuited into this randomized and paraded - group study to receive tither levosimendan or dobutamnine therapy in patients with the aged acute and chronic severe heart failure.In the test group,an initial loading dose of levsimendan of 12μg/kg was infused over 10 min,followed by a continuous infusion of 0.05 -0.1μg/(kg ? min) for for 24 h.In the control group,dobutamine was infused for 1 h at an initial dose of 2μg/(kg·min) without a loading dose,followed by a continuous infusion of 4μg/(kg ? min) for23 h,Clinical assessment was performed to evaluate efficacy and safety of the medications.Results A fatal of 141 patients were evaluate;71 assigned to levosimendan and 70 assigned to dobutamine group.The effectiveness rate was 32.4%(23/71) in the levosimendan group and 17.1%(12/70) in the do butamine group(P <0.01 );At 24 h,left ventricaular ejection fraction(LVEF) was improved by 6.2%in the levosimendan group,compared with 4.5%in the dobutamine group(P > 0.05 );Stoke volume (SV) was increase by 11.8 ml in the levosimendan group and 3.2 ml in the dobutamine group respectively(P < 0.05 ); Dyspnea and clinic manifestations improvements improvements were more significant in levosimendan therapy group compared to dobutamine group.There were the less adverse effects including hypokalemia,hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group(P < 0.05).Conclusion Compared with conventional medications, levosimendan was well tolerated and superior to dobutamine for the aged acute and chronic severe patients with heart failure.更多还原