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目的:探讨左西孟旦对脓毒症患者心肌损伤影响。方法:选取宁波市鄞州区第二医院2015年6月至2017年9月收治的脓毒症伴心肌损伤患者82例，采用随机数字表法分为对照组和治疗组，各41例，在常规基础治疗上，对照组予以多巴酚丁胺治疗，治疗组给予左西孟旦治疗。比较两组治疗前后心型脂肪酸结合蛋白（H-FABP）、肌钙蛋白I（cTnI）、N-末端脑钠钛前体（NT-proBNP）、左室射血分数（LVEF）、急性生理学和慢性健康状况评分Ⅱ（APACHEⅡ）的变化及ICU住院时间、28 d生存情况。结果:治疗前，两组患者H-FABP、cTnI、NT-proBNP各指标及LVEF、APACHEⅡ评分等差异均无统计学意义（均n P>0.05）；治疗后6 h，两组患者H-FABP、cTnI、NT-proBNP水平［（26.22±7.22）μg/L比（39.93±9.85）μg/L，（25.97±6.93）μg/L比（34.86±8.55）μg/L，（0.004±0.002）μg/L比（1.580±0.360）μg/L，（0.003±0.003）μg/L比（0.760±0.210）μg/L，（1 561.73±633.70）ng/L比（2 570.06±747.95）ng/L，（1 602.28±681.45）ng/L比（2 225.53±585.14）ng/L］均较治疗前升高，差异均有统计学意义（n t=7.188、5.172、28.031、23.079、6.586、4.443，均n P0.05）。n 结论:左西孟旦能降低脓毒症患者H-FABP、cTnI、NT-proBNP水平和APACHEⅡ评分，提高LVEF水平，减轻患者心肌损伤。“,”Objective:To investigate the effect of levosimendan on myocardial injury in patients with sepsis.Methods:Eighty-two patients with sepsis complicated by myocardial injury who received treatment in Yinzhou Second Hospital from June 2015 to September 2017 were included in this study. They were randomly assigned to receive either dobutamine treatment (control group, n = 41) or levosimendan treatment (study group, n n = 41) based on conventional basic treatment. Before and after treatment, serum levels of heart-type fatty acid-binding protein (H-FABP), cardiac troponin I (cTnI), N-terminal pro brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LEVF), Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score, intensive care unit (ICU) stay, and 28-day mortality were compared between the control and study groups.n Results:Before treatment, there were no significant differences in serum levels of H-FABP, cTnI, and NT-proBNP as well as LVEF and APACHE II score between the control and study groups (all n P > 0.05). At 6 hours after treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the control and study groups [(26.22 ± 7.22) μg/L n vs. (39.93 ± 9.85) μg/L, (25.97 ± 6.93) μg/L n vs. (34.86 ± 8.55) μg/L, (0.004 ± 0.002) μg/L n vs. (1.580 ± 0.360) μg/L, (0.003 ± 0.003) μg/L n vs. (0.760 ± 0.210) μg/L, (1 561.73 ± 633.70) ng/Ln vs. (2 570.06 ± 747.95) ng/L, (1 602.28 ± 681.45) ng/L n vs. (2 225.53 ± 585.14) ng/L] were significantly increased compared with before treatment (n t = 7.188, 5.172, 28.031, 23.079, 6.586, 4.443, all n P < 0.05). After treatment, serum levels of H-FABP, cTnI, and NT-proBNP in the study group were significantly lower than those in the control group ( n t = 2.489, 12.598, 2.323, all n P < 0.05). In each group, serum level of H-FABP at 72 hours after treatment was significantly lower than that at 6 hours after treatment [(39.93 ± 9.85) μg/L n vs. (6.28 ± 1.07) μg/L, (34.86 ± 8.55) μg/L n vs. (5.82 ± 1.88) μg/L], serum levels of cTnI and NT-proBNP at 72 hours after treatment were significantly increased compared with those at 6 hours after treatment [(1.58 ± 0.36) μg/Ln vs. (2.72 ± 0.55) μg/L, (0.76 ± 0.21) μg/L n vs. (1.78 ± 0.49) μg/L, (2 570.06 ± 747.95 ) ng/L n vs. (3 623.27 ± 1 105.28) ng/L, (2 225.53 ± 585.14) ng/L n vs. (3 128.08 ± 1 098.07) ng/L, n t = 11.105, 12.251, 5.053, 4.645, all n P < 0.05). At 72 hours after treatment, serum levels of cTnI and NT-proBNP levels in the control group were significantly higher than those in the study group ( n t = 8.171, 2.035, both n P 0.05). At 72 hours after treatment, APACHE II score in each group was significantly decreased and LVEF in each group was significantly increased compared with before treatment ( n t = 7.718, 11.380, 9.049, 9.501, all n P < 0.05). The change in APACHE II score at 72 hours after treatment relative to before treatment in the study group was more obvious than that in the control group ( n t = 2.583, n P 0.05).n Conclusion:Levosimendan can reduce the serum levels of H-FABP, cTnI and NT-proBNP as well as APACHE II score in patients with sepsis, increase serum level of LVEF, and alleviate myocardial injury.