【摘要】 目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后泵衰竭应用左西孟旦的疗效及安全性。方法选取2018年1月～2019年1月我院收治的68例AMI PCI术后泵衰竭患者,采用随机数字表法分为对照组和观察组,每组各34例。对照组采用米力农治疗,观察组采用左西孟旦治疗,于治疗7、30 d时行心脏彩超检查和临床指标检测,比较两组临床疗效及安全性。结果两组治疗30 d时左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、心率(HR)、脑钠肽(BNP)、血肌酐(SCr)低于同组治疗7 d时,差异有统计学意义(P<0.05)。两组治疗30 d时左心室射血分数(LVEF)、6 min步行距离高于同组治疗7 d时,差异有统计学意义(P<0.05)。两组治疗30 d时尿量多于同组治疗7 d时,差异有统计学意义(P<0.05)。观察组治疗30 d时LVEDD、LVESD、心率、BNP、SCr低于对照组,差异有统计学意义(P<0.05)。观察组治疗30 d时LVEF高于对照组,6 min步行距离长于对照组,差异有统计学意义(P<0.05)。观察组治疗30 d时尿量多于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论左西孟旦可显著改善AMI PCI术后泵衰竭患者的心功能,且安全性高,值得临床推广使用。更多还原

【Abstract】 Objective To investigate efficacy and safety of Levosimendan in treatment for pump failure after percutaneous transluminal coronary intervention(PCI) in patients with acute myocardial infarctiony(AMI). Methods A total of68 AMI patients with pump failure after PCI were selected in our hospital from January 2018 to January 2019, they were divided into control group and observation group according to random number table method, 34 cases in each group. The control group was treated with Milrinone, the observation group was treated with Levosimendan. Cardiac color doppler ultrasonography and clinical indicators were detected at time of treatment 7, 30 d. Clinical efficacy and safety were compared between two groups. Results Left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic dimension(LVESD), heart rate(HR), brain natriuretic peptide(BNP), creatinine(SCr) at time of treatment30 d in two groups were lower than those at time of treatment 7 d, the differences were statistically significant(P<0.05).LVEF, at time of treatment 30 d in two groups were higher than that at time of treatment 7 d, 6-minute walking distance was longer than that of the control groupo, the differences were statistically significant(P<0.05). Urine volume at time of treatment 30 d in two groups was more than that at time of treatment 7 d, the difference was statistically significant(P<0.05). LVEDD, LVESD, HR, BNP, SCr at time of treatment 30 d in observation group were lower than those of the control group, the differences were statistically significant(P<0.05). LVEF, 6-minute walking distance at time of treatment 30 d in observation group were higher than those of the control group, the differences were statistically significant(P<0.05). Urine volume at time of treatment 30 d in observation group was more than that of the control group,the difference was statistically significant(P<0.05). Total effective rate in observation group was higher than that of the control group, the difference was statistically significant(P<0.05). Total incidence of adverse reactions in observation group was lower than that of the control group, the difference was statistically significant(P<0.05). Conclusion Levosimendan can significantly improve cardiac function of AMI patients with pump failure after PCI, which has high safety and worth of clinical application.更多还原