【摘要】 目的探讨左西孟旦联合无创正压通气(NPPV)治疗急性心肌梗死(AMI)后急性左心衰竭的临床效果及安全性。方法选取2012年1月~2014年12月在本院心内科诊断为AMI合并急性左心衰竭的患者62例,所选患者均在常规药物治疗无效的基础上,给予左西孟旦联合NPPV治疗。观察治疗前及治疗24 h及72 h后,呼吸困难程度及全身临床状况、氧分压、N末端脑利钠肽前体(NT-pro BNP)、超敏C反应蛋白(hs-CRP)的变化。结果与治疗前比较,治疗后,患者的呼吸困难程度评分[24 h(1.32.±0.56)分及72 h(1.21±0.53)分]及全身临床状况评分[24 h(1.16±0.61)分及72 h(1.10±0.58)分]明显改善,氧分压[24 h(91.6±7.2)mm Hg]明显升高(P<0.05),NT-pro BNP水平明显降低[72 h(1435.3±397.8)ng/L](P<0.05),hs-CRP也明显降低[72 h(3.8±1.7)mg/L](P<0.05)。结论左西孟旦联合NPPV治疗急性心肌梗死后急性左心衰竭的效果显著,能够较快改善临床症状,提高氧分压,降低NT-pro BNP、hs-CRP水平,耐受性和安全性良好。更多还原

【Abstract】 Objective To probe into the clinical efficacy and safety of levosimendan combined with noninvasive positive pressure ventilation(NPPV) in the treatment of acute left heart failure after acute myocardial infarction(AMI).Methods From January 2012 to December 2014,62 patients diagnosed as AMI complicated with acute left heart failure in our craniological department of our hospital were selected.On the ineffective basis with conventional drug treatment for selected patients,they were given levosimendan combined with NPPV treatment.The change of dyspnea degree,general clinical status,oxygen partial pressure,N-terminal pro-brain nitric peptide(NT-pro BNP),and high-sensitivity C-reactive protein(hs-CRP) were observed before treatment and after 24 h and 72 h treatment. Results Compared with before treatment,score of dyspnea degree [24 h(1.32.±0.56) points and 72 h(1.21±0.53) points] and general clinical status [24 h(1.16±0.61) points and 72 h(1.10±0.58) points] was obviously improved,and oxygen partial pressure [24 h(91.6±7.2) mm Hg] was significantly increased,and NT- pro BNP [72 h(1435.3±397.8)ng/L] and hs-CRP [72 h(3.8±1.7)mg/L] level was obviously decreased(P<0.05). Conclusion Levosimendan combined with NPPV in the treatment of acute left heart failure after acute myocardial infarction can obtain a remarkable effect,and quickly improve clinical symptoms and oxygen partial pressure,and decrease NT-pro BNP and hs-CRP level with good tolerance and safety.更多还原