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目的:观察左西盂旦治疗急性失代偿性心力衰竭(ADHF)的疗效以及对高敏C反应蛋白(hs-CRP)、白介素(IL-8)、肿瘤坏死因子α(TNF-α)和N-末端脑钠钛前体(NT-proBNP)水平的影响。方法:选择在我院心血管内科治疗的ADHF 86例,随机分为观察组和对照组各43例。两组均给予利尿药、血管扩张药、洋地黄类药物等常规治疗,观察组在此基础上给予左西孟旦微泵注射,对照组给予盐酸多巴酚丁胺治疗。7天后采用彩色多普勒超声仪检测左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD),计算左室射血分数(LVEF)以评估患者心功能改善情况;检测并比较两组hs-CRP、IL-8、TNF-α及NT-proBNP等炎性因子水平。结果:观察组显效率48.8%,显著高于对照组的27.9%(P<0.05);总有效率93.0%,非常显著高于对照组的67.4%(P<0.01)。治疗后,两组LVEDD、LVESD均显著低于治疗前,观察组LVEIDD、LVESD显著低于对照组(P<0.05);两组LVEF水平均显著高于治疗前,观察组LVEF水平显著高于对照组(P<0.05)。两组hs-C:RP、IL-8、TNF-α及NT-proBNP水平均显著低于治疗前,观察组hs-CRP、IL-8、TNF-α及NT-proBNP水平显著低于对照组(P<0.05)。结论:左西孟旦治疗ADI-IF效果较好,可促进患者心功能恢复,改善炎症反应。
OBJECTIVE: To observe the curative effect of left-civendi on acute decompensated heart failure (ADHF) and the effects of high sensitivity C-reactive protein (hs-CRP), interleukin (IL) -8, tumor necrosis factor alpha (TNF- - terminal brain natriuretic peptide (NT-proBNP) levels. Methods: Eighty-six patients with ADHF undergoing cardiovascular medicine in our hospital were randomly divided into observation group (43 cases) and control group (43 cases). Both groups were given diuretics, vasodilators, digitalis and other conventional treatment, the observation group on the basis of levosimendan micro-pump injection, the control group was treated with dobutamine hydrochloride. Seven days later, the left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic dimension (LVEDD) were measured by color Doppler sonography, and left ventricular ejection fraction (LVEF) was calculated to evaluate the improvement of cardiac function. hs-CRP, IL-8, TNF-α and NT-proBNP and other inflammatory factors. Results: The effective rate of observation group was 48.8%, significantly higher than that of control group (27.9%, P <0.05). The total effective rate was 93.0%, which was significantly higher than that of control group (67.4%, P <0.01). After treatment, LVEDD and LVESD in both groups were significantly lower than before treatment, LVEIDD and LVESD in observation group were significantly lower than those in control group (P <0.05); LVEF levels in both groups were significantly higher than those before treatment, LVEF levels in observation group were significantly higher than those in control group Group (P <0.05). The levels of hs-C: RP, IL-8, TNF-α and NT-proBNP in the two groups were significantly lower than those before treatment, and the levels of hs-CRP, IL-8, TNF-α and NT-proBNP in the observation group were significantly lower than those in the control group (P <0.05). Conclusion: Levosimendan treatment of ADI-IF better, can promote recovery of patients with cardiac function and improve the inflammatory response.