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目的观察左西孟旦治疗急性失代偿性心力衰竭(ADHF)并发急性肾损伤(AKI)患者的临床疗效和安全性。方法选取60例ADHF并发AKI患者,随机分为对照组(多巴酚丁胺组)和观察组(左西孟旦组)各30例,比较两组患者治疗前后血浆B型脑利钠肽(BNP)水平及左室射血分数(LVEF)和左室舒张末期内径(LVEDD)评价左心功能,以及比较两组患者治疗前后血肌酐(Cr)、血浆胱抑素C(CysC)水平和计算肾小球滤过率(GFR)评价肾脏功能改善情况,同时观察两组患者药物不良反应发生情况。结果治疗后两组患者血浆BNP水平较治疗前明显下降,LVEF较治疗前升高,且观察组改善程度优于对照组;两组患者血Cr和CysC水平治疗后较治疗前明显下降,且观察组CysC水平下降更显著;GFR治疗后较治疗前升高,观察组较对照组升高更显著。以上比较差异均有统计学意义(P<0.05)。结论左西孟旦能够显著改善ADHF患者左心功能,提高左室排血量,有效治疗因ADHF而引起的急性肾功能损伤。
Objective To observe the clinical efficacy and safety of levosimendan in the treatment of patients with acute decompensated heart failure (ADHF) and acute kidney injury (AKI). Methods Sixty ADHF patients with AKI were randomly divided into control group (dobutamine group) and observation group (levosimendan group), 30 patients in each group were compared before and after treatment of plasma B-type brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) were measured. The levels of serum creatinine (Cr), cystatin C (CysC) Glomerular filtration rate (GFR) to assess the improvement of renal function, while observing the two groups of patients with adverse drug reactions. Results After treatment, plasma BNP levels in both groups were significantly lower than those before treatment, LVEF was higher than before treatment, and the improvement in the observation group was better than that in the control group. The levels of Cr and CysC in both groups were significantly lower than those before treatment The level of CysC decreased more significantly; GFR treatment than before treatment increased, the observation group increased more significantly than the control group. The above differences were statistically significant (P <0.05). Conclusion Levosimendan can significantly improve the left ventricular function in patients with ADHF, increase the amount of left ventricular drainage, and effective treatment of acute renal injury caused by ADHF.