| Objective: To observe the short-term efficacy and safety of levosimendan combined with recombinant human brain natriuretic peptide in the treatment of acute heart failure.Methods: from January 2017 to January 2019,60 patients were selected from the Department of Cardiology,Hunan Brain Hospital,who met the inclusion criteria of acute or chronic heart failure in the decompensated period.The patients and their families signed and agreed to use levosimendan or levosimendan combined with recombinant human brain natriuretic peptide.The patients were included in 1:1,and 60 patients were finally included,.including 30 levosimendan(levo group)and 30 combined group(rh BNP)+ Levo group).There was no significant difference between the two groups in age,gender,basic disease,course of disease,heart function grade and other general basic data(P > 0.05).On the basis of routine anti heart failure treatment,levosimendan group was given levo(Qilu Pharmaceutical Co.,Ltd.)for 24 hours,the first load was 12 μ g / kg,intravenous injection for 10 minutes,and then maintained 0.1 μ g /(kg · min),continuous intravenous pump for 23h50min;combined group: on the basis of pump into levosimendan,rh BNP(Chengdu Nuodi biopharmaceutical Co.,Ltd.)was injected intravenously for 3 minutes with a load of 1.5 μ g / kg,and then continuous micro pump for 72 hours with a speed of 0.0075 μ g /(kg · min).The changes of systolic blood pressure,heart rate,respiratory frequency and 24-hour urine volume were recorded,and the clinical efficacy,NT-pro BNP,LVEF,LVEED,liver and kidney function,electrolyte and other indexes of the patients were observed before and 72 hours after treatment,as well as the adverse reactions of the drugs were recorded.Results: 1.After treatment,the respiratory rate and heart rate of the two groups improved significantly(p< 0.05),but there was no significant difference between the two groups(p > 0.05).After treatment,the blood pressure in levosimendan group and combined group decreased,but there was no significant difference between the two groups(p> 0.05).After treatment,the urine volume of the two groups increased significantly.The urine volume of the combined group was higher than that of the levosimendan group,the difference was statistically significant.(p<0.05)2.After treatment,the clinical symptoms of heart failure in the two groups were significantly improved.Compared with levosimendan,the improvement rate of clinical symptoms in the combined group was significantly higher than that in the control group(p =0.03).3.After treatment,NT-pro BNP of the two groups decreased significantly(p< 0.05),and the combined group decreased more significantly than the control group(p< 0.05).After treatment,the LVEF of the two groups was significantly higher than that of the zuoximendan group,the difference was statistically significant(p= 0.04).The LVEDD of the two groups was lower than that before treatment,but there was no significant difference between the two groups.4.After treatment,there was no significant change in liver and kidney function and electrolyte between the two groups(p>0.05).5.During the treatment,one case of hypotension and one case of headache occurred in levosimendan group.Two cases of hypotension and one case of transient sinus tachycardia after treatment in the combined group,After adjusting the dosage and symptomatic support treatment in time,they were significantly relieved,and the difference was not statistically significant.There were no adverse reactions such as digestive tract reaction,arrhythmia,liver and kidney function damage,skin rash and no serious adverse reactions in the two groups.Conclusion:compared with levosimendan alone,levosimendan combined with recombinant human brain natriuretic peptide can significantly increase the urine volume,improve the cardiac function index of patients,improve the clinical efficacy and safety. |
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