| Objective:On the basis of conventional drug therapy based on the use of levosimendan injection,study and explore the safety and clinical efficacy in elderly patients with decompensated heart failure Levosimendan treatment. Methods:Selecting 142 cases of heart failure patients,both in December 2013-in patients with heart failure Bethune First Hospital of Jilin University in the diagnosis and treatment of cardiovascular medical centers were in November 2015 period, 77 males and 65 females, were aged people(World Health Organization definition of elderly people over the age of 60. in the definition of Chinese citizens over 60 years old for the elderly), the average age(74.10±11.54) years old, are in line with the clinical diagnosis of heart failure(refer to Chen Hao Zhu, Zhong Nanshan within science.8th edition.2013) diagnostic criteria for hospitalized patients,and in accordance with NYHA functional classification method, in NYHA class III-IV and LVEF(LVEF) <40% of patients were randomly divided into levosimendan group(n=71) and milrinone group(n=71 patients), two groups of patients in general and the underlying disease was no significant difference in both groups were treated with conventional therapy, including ACEI(angiotensin converting enzyme inhibitors) or ARB, β-blockers, diuretics,MRA(aldosterone receptor antagonist). experimental group(levosimendan) in conventional drug given on the basis of levosimendan injection 5ml 0.9%sodium chloride injection diluted to 50 ml initial loading dose 0.2ug/kg/min,intravenous infusion 10 min,such as the patient can tolerate,then with 0.2ug/kg/min continuous intravenous infusion 24 h.the control group(milrinone group) given milrinone injection 3mg in conventional drug treatment based on diluted to 20 ml with 0.9%sodium chloride injection,infusion within 15 min,30min after such patients can be resistant by,followed by milrinone injection 7mg with 0.9%sodium chloride injection diluted to 100 ml,infusion over 2 hours,for 3 consecutive days.Monitored before treatment and after 5 days the patient’s vital signs,and laboratory-related indicators as well as cardiac function,comprehensive evaluation of the effectiveness of drug treatment,while recording cardiovascular adverse events occurred in patients during treatment and adverse reactions. Results:1.in the conventional treatment based on the comparison group and milrinone,levosimendan plus injection more significant improvement in elderly patients with decompensated heart failure and dyspnea cardiac function.2.in the conventional treatment based on the comparison of the experimental group and the control group,the experimental group significantly increased in elderly patients with decompensated heart failure left ventricular EF,SV(stroke volume),and can effectively reduce the level of NT-pro BNP:the treated group after 5 days left ventricular EF,SV difference compared with the control group was statistically significant(respectively,t=5.157,P<0.01.t=3.274,P<0.01).experimental treatment group seven days, NT-pro BNP reduce the level of the control group was statistically significant differences compared to(t=-3.248, P<0.05).3.in the conventional treatment based on the amount of injection and left West milrinone group compared levosimendan injection can significantly reduce left ventricular end-diastolic diameter,and the difference was statistically significant(P<0.05).4.in the conventional therapy based on the use of injection or the amount left West milrinone injection of liver function,renal function,blood K had no effect,the difference was not statistically significant(P>0.05).5.in the conventional therapy based on the use of injection or the amount left West milrinone,little effect on the increase in adverse reactions and cardiovascular adverse events,and the difference was not statistically significant(P>0.05). Conclusions:1.on the basis of conventional therapy with milrinone group compared levosimendan injection improved significantly more in elderly patients with decompensated heart failure and dyspnea cardiac function.levosimendan treatment 5 days after heart failure patients to improve the degree of dyspnea and the degree of improvement in cardiac function were better than milrinone group.2.in the conventional treatment of heart failure drugs on the use of levosimendan injection can reduce the plasma NT-pro BNP levels and LVED level,more significantly improved LVEF,SV.3.the basis of conventional drug treatment of heart failure based on the use of levosimendan better safety.4.levosimendan injection in the treatment of heart failure,not only can improve the prognosis of patients with heart failure,can reduce their risk of death. |
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