| Objective:Investigate the clinical efficacy of levosimendan in the treatment of elderly patients with severe heart failure.Methods:In this experiment,a total of 138 cases of elderly patients with severe heart failure patients,all patients were admitted to our hospital during January 2014-2015 December,were randomly divided into two groups,namely the research group(n=68)and control group(n=70).In the study group,49 cases of patients with coronary heart disease,the elderly patients with degenerative valvular heart disease in 15 cases.4 cases of patients with dilated cardiomyopathy;control group,51 cases of patients with coronary heart disease,the elderly patients with degenerative valvular heart disease in 16 cases,3 cases of dilated cardiomyopathy patients.Two groups of patients underwent conventional heart failure treatment,while the patients of study group were given a levosimendan(Yue Wen,specifications:5ml,12.5mg/,Qilu pharmaceutical)injection in the treatment of 10min.the initial load is given 12ug/kg intravenous injection,followed by 0.1 g/(kg?min)micro volume pump,1h after the infusion rate increased to 0.2 g/(kg?min)for 24h;refer to the treatment group 7d was added with agricultural power injection.Clinical symptoms were assessed before treatment,at 8D and 1 month after discharge,and blood samples were taken,NT-proBNP,ultrasonography,LVEF and FS,and safety evaluation were performed.Results:(1)two groups of dyspnea and quantitative biomarker NT-proBNP level comparison results:before the treatment of dyspnea group and control group Borg scores were(8.2±1.3),(8.3±1.4),after eighth days of treatment of dyspnea symptoms were significantly improved,Borg score was(1.2±0.5)and(2.6±0.7),were significantly lower than before treatment,the difference was statistically significant(P<0.05);comparison between the two groups after treatment,the study group is lower,the difference was statistically significant(P<0.05),suggesting the study group of dyspnea improved better;the treatment before the NT-proBNP level of study group for(26842.6±411.4),the control group is(26783.3±488.4),there is ino significant difference between the two groups(P>0.05).The level of NT-proBNP in the study group(10274.6±445.7)was eighth day,and the reference group was(12956.2±403.5).Compared with before treatment.the difference was statistically significant(P<0.05);between the two groups,the level of NT-proBNP in the study group was lower than that of the reference group,the difference was statistically significant(P<0.05).After 1 month study group(n=55)NT-proBNP level(7012.6±415.3),control group(n=56)for(9526.2±423.5),were significantly reduced at the time of admission,the difference was statistically significant(P<0.05);comparison between groups of group NT-proBNP were more than the reference group,there were statistically significant differences(P<0.05).(2)The comparison of two groups of ultrasonic examination indexes:(1)before the treatment,the LVEF of the study group was(35.06±4.9),and the reference group was(34.07±4.8),there was no significant difference between the two groups(P>0.05).Eighth days after treatment,the LVEF in the study group was(36.67±4.8),and the reference group was(35.53±4.6).The left ventricular ejection fraction in the two groups was not significantly better than that before the treatment(P>0.05),and there was no significant difference between the two groups(P>0.05).After 1 month study group(n=55)LVEF(41.061±4.2),control group(n=56)LVEF(38.07±4.3),were better than those before treatment.there were statistically significant differences(P<0.05),between the two groups of LVEF was higher than that of the reference group,the difference had statistical meaning Yi(P<0.05).The research group and control group before treatment,left ventricular fractional shortening(FS)respectively(17.63±2.8),(17.42±2.7),medication for eighth days of group FS(22.66±2.7),according to group FS(20.02±2.5),the two group compared with before treatment,the difference was there were statistically significant(P<0.05).Compared between the two groups,the study group improved more obvious effect,the difference was statistically significant(P<0.05);after 1 month study group(n=55)and control group(n=56)FS respectively(26.63±2.8),(22.42±2.7),were better than those before treatment,there were statistically significant differences(P<0.05);between the two groups of FS group than the control group,the difference was statistically significant(P<0.05).(3)Safety comparison:In the 7 days in the group occurred in 2 cases of hypokalemia,1 cases of headache and dizziness,2 cases of hypotension,3 cases of ventricular arrhythmia,the incidence of adverse reaction was 11.42%(8/70),in addition to the 1 cases of hypokalemia were treated with potassium,1 cases of hypotension in patients with slow infusion rate and 1 cases of ventricular tachycardia as early as two and 1 cases of ventricular bigeminy patients by antiarrhythmic therapy after recovery.the other adverse reactions are mild,no treatment;1 cases of headache,1 cases of hypotension in the study group,the incidence rate of adverse reaction was 2.94%(2/68),and the adverse reactions were mild,no special treatment to restore.After 1 month of liver function and renal function of two groups were no obvious abnormalities,the study group(n=55)had no adverse reactions,the reference group(n=56)and 1 cases of hypokalemia,taking diuretics induced.Conclusion:Levosimendan can effectively improve the symptoms of dyspnea in elderly patients with severe heart failure,and has high safety. |
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