Objective:Analysis the clinical effect of leosimendan in patients with refractory heart failure,provide a basis for clinical standardized application of levosimendan. Methods:The 261 patients with refractory heart failure received the standard of heart failure therapy, 154 patients with ischemic cardiomyopathy, 107 patients with nonischemic cardiomyopathy. According to whether the application of levosimendan, 154 patients were devide into Control group(n=59) and Medical group(n=95); 107 patients were devide into Control group(n=54) and Medical group(n=53);According to the different primary disease,patients with levosimendan therapy were divided into NICM group(n=53) and ICM group(n=95); According to the different age,they were divided into nonaging group(n=66) andaging group(n=82). Monitoring indicators: 1) The change level of Na, K,Cl, Hb, Scr, BUN, UA, TnT andNT-proBNPLV,LVEF and PAP at before treatment or 48 hours after the end of using levosimen dan;2)Patient’s blood pressure at before treament or 1 hour, 24 hours, 48 hours and 72 hours after using levosimendan medication; 3) The change of cardiac function; 4) P atients’ length of stay; 5) The mortaliy rate of patients in hospital.Result:1. In heart failure patients with ischemic cardiomyopathy, the results show that this medication usage can improve the monitor factor including the difference of LV,LVEF,PAP,NT-proBNP,BUN,Cre,UAand the level of cardiac function NYHA effectively, P<0.05. The reduced level of K,Na and Hb in Medical group is higher than that of control group. The difference before and after medication in K,Na,Hb Medical group is greater than the control group, P<0.05.2.In heart failure patients with nonischemic cardiomyopathy, the results show that this medication usage can improve the monitor factor including the difference of LVEF,NT-proBNP,TnT,UAand the level of cardiac function NYHA in 48 hours after treament effectively, P<0.05. The reduced level of K,Na and Hb in Medical group is higher than that of control group. The difference before and after medication in K, Hb Medical group is greater than the control group, P<0.05.3. In theNICM group and ICM group: The difference before and after medication in LVEF,LV,PAP,NT-proBNP,TnT,BUN,Cre,UA,K,the length of hospital stay,mortality of in-hospital and the improve level of cardiac function NYHA in 48 hours after medical, ICM group was better than the NICM group, P<0.05;Medical group is greater than the control group, P < 0.05.4. In the nonaging group and aging group: levosimendan can improve the level of LVEF, reduce the PAP, NT-pro BNP, TNT, BUN, UA, and blood pressure, improve LV and cardiac function NYHA level. The difference before and after medication in NT-proBNP,TnT and Cre, Older group was better than the unOlder group, P < 0.05. Conclusion:1.Levosimendan can effectively improve the LVEF,NT-pro BNP,TnT,BUN andcardiac function NYHA classification level at 48 hours after treatment of refractory patients with systolic heart failure,reduceblood pressure and the level of K, Na and Hb and improve the LV,PAP, Cre,UA and cardiac function NYHA classification level at 7 day after medication in patients with ischemic cardiomyopathy. However, there are no effects on length of hospital stay and hospital mortality of the patients.2.Levosimendan can effectively improve the LVEF,NT-proBNP,TnT,BUN,Cre and cardiac function NYHA classification level at 48 hours after treatment of patients with ischemic cardiomyopathy and reduce the length of hospital stay and hospital mortality of the patients compared with patients with heart failure patients of nonischemic cardiomyopathy.3. Levosimendan can effectively improve the level of NT-proBNP, TnT,Cre and cardiac function NYHA classification level at 7 day after medication in older patients. But there is no statistical difference in the length of hospital stay and hospital mortality of the patients. |