[1]韩亚军,张荣怀,王晓明.左西孟旦注射液和托拉塞米注射液联合治疗老年慢性心力衰竭疗效观察[J].新乡医学院学报,2021,38(1):057-61.[doi:10.7683/xxyxyxb.2021.01.012]
　HAN Yajun,ZHANG Ronghuai,WANG Xiaoming.Curative effect of levosimendan injection combined with torasemide injection in the treatment of elderly patients with chronic heart failure[J].Journal of Xinxiang Medical University,2021,38(1):057-61.[doi:10.7683/xxyxyxb.2021.01.012]
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左西孟旦注射液和托拉塞米注射液联合治疗老年慢性心力衰竭疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年1
页码:
057-61
栏目:
临床研究
出版日期:
2021-01-05

文章信息/Info

Title:
Curative effect of levosimendan injection combined with torasemide injection in the treatment of elderly patients with chronic heart failure
作者:
韩亚军1; 张荣怀2; 王晓明1
（1.空军军医大学第一附属医院老年病科，陕西　西安　710032；2.陕西省人民医院心内科，陕西　西安　710068）
Author(s):
HAN Yajun1; ZHANG Ronghuai2; WANG Xiaoming1
(1.Department of Geriatrics,the First Affiliated Hospital of Air Force Military Medical University,Xi′an 710032,Shaanxi Province,China2.Department of Cardiology,Shaanxi Provincial People′s Hospital,Xi′an 710068,Shaanxi Province,China)
关键词:
慢性心力衰竭; 左西孟旦; 托拉塞米; 心功能; 心型脂肪酸结合蛋白; N-末端脑钠肽前体
Keywords:
chronic heart failurelevosimendantorasemidecardiac functionheart type-fatty acid binding proteinN-terminal probrain natriuretic peptide
分类号:
R541.61
DOI:
10.7683/xxyxyxb.2021.01.012
文献标志码:
A
摘要:
目的　探讨左西孟旦注射液和托拉塞米注射液联合治疗老年慢性心力衰竭（CHF）的临床效果。方法　选择2013年3月至2019年5月空军军医大学第一附属医院收治的88例老年CHF患者为研究对象，根据治疗方法将患者分为观察组和对照组，每组44例。对照组患者给予托拉塞米注射液治疗，观察组患者给予左西孟旦注射液和托拉塞米注射液联合治疗，疗程均为5 d。对2组患者治疗前后临床症状评分、每搏输出量（SV）、左心室射血分数（LVEF）、6 min步行距离（6MWD）、心功能纽约心脏病学会（NYHA）分级、24 h尿量及血清心型脂肪酸结合蛋白（H-FABP）、N-末端脑钠肽前体（NT-proBNP）、肌酐、钠离子（Na+）、钾离子（K+）水平进行比较。结果　治疗前2组患者肺部啰音、呼吸困难及水肿评分比较差异无统计学意义（P＞0.05），2组患者治疗后肺部啰音、呼吸困难及水肿评分显著低于治疗前（P＜0.05）；治疗后，观察组患者肺部啰音、呼吸困难及水肿评分显著低于对照组（P＜0.05）。治疗前2组患者SV、LVEF、6MWD比较差异无统计学意义（P＞0.05），2组患者治疗后 SV、LVEF、6MWD显著大于治疗前（P＜0.05）；治疗后，观察组患者SV、LVEF、6MWD显著大于对照组（P＜0.05）。治疗前2组患者心功能NYHA分级比较差异无统计学意义（P＞0.05），2组患者治疗后心功能NYHA分级显著优于治疗前（P＜0.05）；治疗后，观察组患者心功能NYHA分级显著优于对照组（P＜0.05）。治疗前2组患者血清H-FABP、NT-proBNP水平比较差异无统计学意义（P＞0.05），2组患者治疗后血清H-FABP、NT-proBNP水平显著低于治疗前（P＜0.05）；治疗后，观察组患者血清H-FABP、NT-proBNP水平显著低于对照组（P＜0.05）。治疗前2组患者血清Na+、K+、肌酐水平及24 h尿量比较差异无统计学意义（P＞0.05）；与治疗前比较，2组患者治疗后血清Na+水平显著降低，血清肌酐水平显著升高，24 h尿量显著增加（P＜0.05）；对照组患者治疗后血清K+水平显著低于治疗前（P＜0.05），观察组患者治疗后与治疗前血清K+水平比较差异无统计学意义（P＞0.05）；治疗后，观察组患者血清K+水平显著高于对照组，24 h尿量显著大于对照组（P＜0.05）；治疗后，2组患者血清Na+、肌酐水平比较差异无统计学意义（P＞0.05）。结论　左西孟旦注射液联合托拉塞米注射液可以有效减轻老年CHF患者的心肌损害，改善患者的临床症状和心功能，增加尿量，且对血清K+水平影响较小。
Abstract:
Objective　To investigate the clinical effect of levosimendan injection combined with torasemide injection in the treatment of elderly patients with chronic heart failure (CHF).Methods　　A total of 88 elderly patients with CHF admitted to the First Affiliated Hospital of Air Force Military Medical University from March 2013 to May 2019 were selected as the research subjects.The patients were divided into observation group and control group according to the treatment methods,with 44 cases in each group.The patients in the control group were treated with torasemide injection,while the patients in the observation group were treated with levosimendan injection and torasemide injection for five days.The clinical symptom score,stroke volume (SV),left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),New York Heart Association (NYHA) classification of cardiac function,24-hour urine volume and serum heart type-fatty acid binding protein (H-FABP),N-terminal probrain natriuretic peptide (NT-proBNP),creatinine,sodium ion (Na+),kalium ion (K+) levels were compared between the two groups.Results　There was no significant difference in the scores of pulmonary rales,dyspnea and edema between the two groups before treatment (P>0.05).The scores of pulmonary rales,dyspnea and edema after treatment were significantly lower than those before treatment in the two groups (P<0.05).The scores of pulmonary rales,dyspnea and edema in the observation group were significantly lower than those in the control group after treatment (P<0.05).There was no significant difference in SV,LVEF and 6MWD between the two groups before treatment (P>0.05).The SV,LVEF and 6MWD of the patients after treatment were significantly higher than those before treatment in the two groups (P<0.05).The SV,LVEF and 6MWD of the patients in the observation group were significantly higher than those in the control group after treatment (P<0.05).There was no significant difference in NYHA classification of cardiac function between the two groups before treatment (P>0.05).The NYHA classification of cardiac function of the patients after treatment was significantly better than that before treatment in the two groups (P<0.05).The NYHA classification of cardiac function of the patients in the observation group was significantly better than that in the control group after treatment (P<0.05).There was no significant difference in the levels of serum H-FABP and NT-proBNP between the two groups before treatment (P>0.05).The levels of serum H-FABP and NT-proBNP after treatment were significantly lower than those before treatment in the two groups (P<0.05).The levels of serum H-FABP and NT-proBNP in the observation group were significantly lower than those in the control group after treatment (P<0.05).There was no significant difference in serum Na+,K+,creatinine levels and 24-hour urine volume between the two groups before treatment (P>0.05).Compared with before treatment,the serum Na+ level was significantly decreased,the serum creatinine level and the 24-hour urine volume were significantly increased after treatment in the two groups (P<0.05).The serum K+ level after treatment was significantly lower than that before treatment in the control group (P<0.05).There was no significant difference in serum K+ level before and after treatment in the observation group (P>0.05).After treatment,the serum K+ level of the patients in the observation group was significantly higher than that in the control group,and the 24-hour urine volume in the observation group was significantly higher than that in the control group (P<0.05),but there was no significant difference in the serum Na+ and creatinine levels between the two groups (P>0.05).Conclusion　Levosimendan injection combined with torasemide injection can effectively reduce myocardial damage,improve clinical symptoms and cardiac function,increase urine volume,and has little effect on serum K+ level in elderly patients with CHF.

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更新日期/Last Update: 2021-01-05