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[摘要]
目的 探讨左西孟旦、米力农以及多巴酚丁胺治疗急性失代偿心力衰竭患者的临床疗效及安全性。方法 收取2013年4月-2016年4月间西安市中心医院收治的急性失代偿心力衰竭患者336例作为研究对象,根据入院先后顺序依次进入A、B、C组,每组各112例,分别给予左西孟旦、米力农和多巴酚丁胺进行治疗。对3组患者临床疗效、血流动力学、血清学指标以及安全性进行观察与比较。结果 A组总有效率(90.18%)明显高于B组(58.93%)及C组(65.18%),差异有统计学意义(P<0.05)。治疗后3组患者肺毛细血管楔压(PCWP)、肺动脉平均压(PAMP)、右房压(RAP)及周围血管阻力(SVR)均较治疗前显著下降,差异有统计学意义(P<0.05),A组PCWP、PAMP及SVR明显低于B组及C组(P<0.05)。3组治疗后RAP差异不显著。治疗后3组患者氨基末端B型利钠肽原(NT-proBNP)、内皮素-1(ET-1)以及去甲肾上腺素(NE)水平均较治疗前明显下降(P<0.05);A组显著低于B组及C组(P<0.05)。A组不良反应发生率明显低于B组及C组,差异有统计学意义(P<0.05)。结论 左西孟旦治疗急性失代偿心力衰竭疗效及安全性均显著优于米力农及多巴酚丁胺,值得临床推广应用。
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[Abstract]
Objective To explore the clinical effect and safety of levosimendan, milrinone, and dobutamine in treatment of patients with ADHF. Methods All 336 patients with ADHF accepted in Xi'an Center Hospital from April 2013 to April 2016 were selected and divided into group A, B, and C with 112 cases in each group. Patients in three groups were given levosimendan, milrinone, and dobutamine respectively. Then the clinical effect, hemodynamics, serum indexes, and safety of two groups were observed and compared. Results The total efficacy of group A (90.18%) was obviously higher than group B (58.93%) and group C (65.18%) with statistically significance (P<0.05). PCWP, PAMP, RAP, and SVR of three groups after treatment were lower than before (P<0.05). And PCWP, PAMP, and SVR of group A were obviously lower than those of group B and C (P<0.05). RAP among three groups after treatment had no difference. NT-proBNP, ET-1, and NE of three groups after treatment were lower than before (P<0.05), and group A was obviously lower than group B and C (P<0.05). Adverse reaction rate of group A was obviously lower than that of group B and C with statistically difference (P<0.05). Conclusion Levosimendan has better effect and safety than milrinone and dobutamine in treatment of patients with ADHF, which is worth clinical application.
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