Comparative Study Of Levosimendan And Milrinone On Clinical Efficacy And Safety Of The Treatment Of Intractable Heart Failure

Objective:Clinical observation of the curative effect of levosimendan and milrinone in the treatment of intractable heart failure,and to evaluate the safety of these two drugs.Methods:Methods 80 patients with refractory heart failure from September 2014 to September 2015 in Shanxian County central hospital were selected as the subjects.According to the control,parallel,single blind method,patients were randomly divided into levosimendan group and milrinone group,each group of 40 patients,all patients were treated with conventional treatment of heart failure.Then,the experimental group was treated with levosimendan,the initial loading dose of 12 g/Kg was given intravenously for more than 10 minutes,followed by continuous intr avenous infusion of 0.1ug/(kg.min),1 hours after the appropriate half or double continuous intravenous infusion to maintain a total of 24 hours.The control group was treated with milrinone,given a loading dose of 50ug/kg,intravenous injection for 10 minutes,then to 0.375-0.75ug/kg per minute intravenous maintenance of a total of 24 hours.After 7 days of treatment,observe two groups of patients with dyspnea improvement and heart function classification(NYHA classification);com paring the two groups of N-terminal probrain natriuretic peptide(NT-pro BNP)level,left ventricular ejection fraction(EF),stroke volume(SV);to compare the incid ence of adverse drug reactions in two groups,the number of days in hospital,and the rate of readmission and mortality after a follow-up of 3 months.Results:A week after the treatment results show that the improvement of heart f unction and symptom remission milrinone group total effective rate was 72.5%,while the levosimendan group total effective rate was 92.5%,and the levosimendan group effective rate was 1.7 times the milrinone group,significant statistical differ ences between the two groups of experimental data on P<0.05(two);group LVEF and SV were significantly higher than that before treatment,the therapeutic effect of milrinone significantly less than levosimendan treatment effect is good,the difference between the two groups was statistically significant(P<0.05);to reduce the NT-pro BNP value,levosimendan group decreased compared with milrinone group was more significantly,the difference was statistically significant(P<0.05).The ad verse reactions,levosimendan group the overall incidence of adverse reactions was12.5%,milrinone group was 22.5%(9/40),the data differences were statistically significant(P < 0.05).The levosimendan group the average hospitalization was 13.5+ 4.5 days,compared to 16.5 + 6.5 days short of milrinone group,prognosis,le vosimendan group three months readmission rate and mortality compared to milrin one group,there was significant difference between the groups(P < 0.05).Conclusion:1.Levosimendan in the treatment of intractable heart failure clinical curative effect is more significant to milrinone,alleviate dyspnea symptoms and improve heart function classification.2.Compared with milrinone,levosimendan in treatment of obstinate heart failure reflects more advantages in patients: the increase of LVEF and SV;NT-Pro BNP reduction.3.Levosimendan has a good safety in the treatment of refractory heart failure,the average length of hospital stay is less,and there is a tendency to reduce the mortality rate of 3 months and the rate of rehospitalization.