【摘要】 目的 探讨左西孟旦对老年急性失代偿性心力衰竭的临床效果。方法 2019年1月至2021年3月住院治疗的老年急性失代偿性心力衰竭患者共80例作为研究对象，同时按照随机数字表法将纳入患者随机分为对照组和观察组，每组40例。对照组选择常规治疗，观察组在常规治疗基础上应用左西孟旦，比较2组患者的总有效率、心功能指标[NT-proBNP、左心射血分数(LVEF)]、心肌损伤指标[肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、血管内皮功能指标[血管内皮素-1(ET-1)、内皮源性一氧化氮(NO)]、血清炎性因子指标[白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)]、生命质量评分。结果 观察组总有效率高于对照组(P<0.05)。与治疗前相比，2组患者在治疗后NT-proBNP水平均减低(P<0.05),且观察组下降幅度大于治疗组(P<0.05),2组患者的LVEF在治疗后均增高(P<0.05),同时观察组的LVEF升高水平较对照组高(P<0.05)。治疗后，2组患者的cTnI、CK-MB、LDH均降低(P<0.05);且观察组的cTnI、CK-MB、LDH下降幅度均大于对照组(P<0.05)。治疗后2组患者的ET-1均有所下降(P<0.05),NO水平较治疗前均有所升高(P<0.05);治疗后观察组的ET-1与对照组相比更低(P<0.05),观察组的NO水平与对照组相比更高(P<0.05)。与治疗前相比，2组患者的血清IL-6、hs-CRP、PCT水平在治疗后均降低(P<0.05);经治疗，观察组的血清IL-6、hs-CRP、PCT水平比对照组降低幅度更大(P<0.05)。2组患者生命质量评分在治疗后不同程度下降(P<0.05),观察组下降幅度大于对照组(P<0.05)。结论 左西孟旦用于老年急性失代偿性心力衰竭治疗中，可有效减轻血管内皮功能损伤和炎性反应，改善心功能，修复心肌损伤，有利于提高患者生命质量。更多还原

【Abstract】 Objective To explore the clinical effect of levosimendan on elderly patients with acute decompensated heart failure(ADHF).Methods A total of 80 elderly patients with ADHF treated in our hospital from January 2019 to March 2021 were selected as the research objects. They were randomly assigned into control group(n=40) and observation group(n=40). Conventional treatment was given to all patients, and those in the observation group were additionally treated with levosimendan. The total effective rate, cardiac function indexes(N-terminal pro-B-type natriuretic peptide [NT-proBNP], left ventricular ejection fraction [LVEF]), myocardial injury indexes(cardiac troponin I [cTnI], creatine kinase MB [CK-MB], lactate dehydrogenase [LDH]), vascular endothelial function indexes(endothelin-1 [ET-1], nitric oxide [NO]), serum inflammatory factors(interleukin 6 [IL-6], high-sensitivity C-reactive protein [hs-CRP], procalcitonin [PCT]), and quality of life score were compared between groups.Results The total effective rate in the observation group was significantly higher than that in the control group(P<0.05). Significantly decreased NT-proBNP and increased LVEF after treatment were detected in both groups, which were more pronounced in the observation group(all P<0.05).Relative levels of cTnI, CK-MB and LDH were significantly reduced after treatment in both groups, which were more pronounced in the observation group(P<0.05). After treatment, significantly decreased ET-1 level and increased NO level were detected in both groups, which were more pronounced in the observation group(P<0.05). Serum levels of IL-6, hs-CRP and PCT were significantly reduced in both groups, which were more pronounced in the observation group(P<0.05). Scores of the quality of life in both groups were significantly reduced, which were more pronounced in the observation group(P<0.05).Conclusion The application of levosimendan in elderly patients with ADHF can effectively reduce vascular endothelial function injury and inflammatory reaction, improve cardiac function and the quality of life, and repair myocardial injury.更多还原