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目的:比较左西孟旦单次与多次注射给药对晚期心力衰竭急性加重患者左心功能、生物标记物及神经激素活性的影响。方法:39例晚期心力衰竭急性加重患者随机分为单次给予左西孟旦和多次给予左西孟旦治疗2组,所有患者基线时均先静脉给予左西孟旦6μg·kg~(-1)的负荷剂量,继而以0.1μg·kg~(-1)·min~(-1)持续24h静脉泵入,多次给药组在治疗1个月及6个月时分别再以上述方法给药1次。比较两组患者治疗前、治疗3d及治疗6个月时的左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、二尖瓣环收缩速度(Sm)、心肌做功指数(MOI)、血脑钠肽(NT-pro BNP)、肿瘤坏死因子-α(TNF-α)及白介素-6(IL-6)。结果:治疗3d时两组患者的LVESF、LVEF、Sm、MPI、NT-pro BNP、IL-6及TNF-α均较治疗前显著改善(P<0.05);治疗6个月时多次给药组的LVESF、LVEDF、LVEF、Sm、MPI、NT-pro BNP、IL-6及TNF-α等指标分别较本组治疗前和单次给药组同期显著改善(P<0.05)。结论:多次静脉给予左西孟旦在改善血流动力学及炎性因子方面等方面优于单次注射给药。
OBJECTIVE: To compare the effects of levosimendan administered single and multiple injections on left ventricular function, biomarkers and neurohormonal activity in patients with acute exacerbation of advanced heart failure. Methods: Thirty-nine patients with acute exacerbation of heart failure were randomly divided into two groups: levosimendan given once and levosimendan given repeatedly. All the patients were given intravenous levosimendan 6 μg · kg ~ 1), and then pumped intravenously at 0.1 μg · kg -1 (-1) min -1 for 24 h. The rats in multiple administration groups were treated with the above method Administered 1 time. The left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), mitral annulus contraction velocity ( Sm, myocardial work index (MOI), NT-pro BNP, TNF-α and IL-6. Results: LVESF, LVEF, Sm, MPI, NT-pro BNP, IL-6 and TNF-αwere significantly improved in both groups at the third day after treatment (P <0.05) The indexes of LVESF, LVEDF, LVEF, Sm, MPI, NT-pro BNP, IL-6 and TNF-αwere significantly improved compared with the pre-treatment and single-administration groups in this group (P <0.05). CONCLUSION: Levosimendan administered intravenously is superior to single injection in improving hemodynamics and inflammatory cytokines.