作者：王新龙，乔锐，项学军，顾崇怀，杨之

单位：

安徽医科大学附属安庆医院安庆市立医院心内科

Units：

Department of Cardiology, Anqing Hospital Affiliated to Anhui Medical University/Anqing Municipal Hospital, Anqing 246000, China

关键词：

急性心肌梗死; 心力衰竭; 左西孟旦; 主动脉内球囊反搏术; 治疗结果;

Keywords：

Acute myocardial infarction; Heart failure; Leosimendan; Intra-aortic balloon pump; Treatment outcome

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.169

Funds：

2021年度安徽省卫生健康委科研项目（AHWJ2021a167）

摘要：

目的 探讨左西孟旦联合主动脉内球囊反搏术（IABP）治疗急性心肌梗死（AMI）合并心力衰竭的疗效。方法 本研究为随机对照试验，选取2019年1月至2022年9月安庆市立医院心内科收治的AMI合并心力衰竭患者88例为研究对象，采用随机数字表法将患者分为对照组（44例）和研究组（44例）。在急诊PCI基础上，对照组患者采用多巴酚丁胺联合IABP治疗，研究组患者采用左西孟旦联合IABP治疗。比较两组治疗后7 d临床疗效，治疗前、治疗后7 d实验室检查指标[N末端脑钠肽前体（NT-proBNP）、C反应蛋白（CRP）水平]、心脏彩超检查指标[左心室射血分数（LVEF）、左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）、每搏输出量（SV）]，记录两组住院时间、并发症发生情况。结果 治疗后7 d研究组治疗总有效率高于对照组（P<0.05）。治疗后7 d，两组NT-proBNP、CRP水平分别低于本组治疗前，且研究组NT-proBNP、CRP水平低于对照组（P<0.05）。治疗后7 d，两组LVEF分别高于本组治疗前，LVESV、LVEDV分别小于本组治疗前，SV分别大于本组治疗前；且研究组LVEF高于对照组，LVESV、LVEDV小于对照组，SV大于对照组（P<0.05）。两组住院时间、并发症发生率比较，差异无统计学意义（P>0.05）。结论 左西孟旦联合IABP可提高AMI合并心力衰竭患者总有效率，降低炎症因子，改善心功能，且安全性高。

Abstract：

　Objective To investigate the effect of levosimendan combined with intra-aortic balloon pump (IABP) in the treatment of patients with acute myocardial infarction (AMI) and heart failure. Methods This study was a randomized controlled trial. A total of 88 patients with AMI and heart failure admitted to the Department of Cardiology of Anqing Municipal Hospital from January 2019 to September 2022 were selected as study subjects. The patients were divided into control group (44 cases) and study group (44 cases) by random number table method. On the basis of emergency PCI, the patients in the control group were treated with dobutamine combined with IABP, and the patients in the study group was treated with levosimendan combined with IABP. The clinical efficacy 7 days after treatment, laboratory examination indexes [N-terminal pro-brain natriuretic peptide (NT-proBNP) , C-reactive protein (CRP) level] and cardiac ultrasound examination indexes [left ventricular ejection fraction (LVEF) , left ventricular end-systolic volume (LVESV) , left ventricular end-diastolic volume (LVEDV) , stroke volume (SV) ] before treatment and 7 days after treatment were compared between the two groups. Hospitalization time and the occurrence of complications in both groups were recorded. Results Seven days after treatment, the total effective rate of the study group was higher than that of the control group (P < 0.05) . Seven days after treatment, the NT-proBNP and CRP level in the two groups were lower than those before treatment, and the NT-proBNP and CRP level in the study group were lower than those in the control group (P < 0.05) . Seven days after treatment, LVEF in the two groups was higher than that before treatment, and LVESV and LVEDV were smaller than those before treatment, and SV was greater than that before treatment, and LVEF in the study group was higher than that in the control group, LVESV and LVEDV were smaller than those in the control group, and SV was greater than that in the control group (P < 0.05) . There was no significant difference in hospitalization time and the incidence of complications between the two groups (P > 0.05) . Conclusion Levosimendan combined with IABP can improve the total effective rate of patients with AMI and heart failure, reduce inflammatory factors, improve cardiac function, and has high safety.

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