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目的观察丹参酮Ⅱ A联合左西孟旦治疗急性心力衰竭(Olute heart failure,AHF)的临床疗效。方法选择2014年6月—2015年12月收治的AHF患者120例,采用随机数字表法分为对照组及观察组,各60例。对照组在常规治疗基础上加用左西孟旦注射液,连续使用24 h;观察组在对照组的基础上加用丹参酮Ⅱ A磺酸钠注射液,连续使用7 d。记录两组治疗后临床症状、脑钠肽(BNP)水平、平均收缩压及舒张压、平均心率、左心室射血分数(LEVF)及每搏输出量(SV)、左心室舒张末直径(LVEDD)、左室收缩末期内径(LVSDD)等指标,比较两组不良反应发生率、病死率及再入院率。结果治疗24 h后,两组BNP、平均收缩压及舒张压、平均心率、SV、LEVF比较,差异有统计学意义(均P>0.05);两组LVEDD、LVESD比较,差异无统计学意义(均P>0.05)。总有效率观察组为83.3%优于对照组70.0%(P<0.05)。治疗3个月后,观察组LEVF、LVEDD、LVESD均优于治疗前且优于治疗后的对照组,差异有统计学意义(均P<0.05)。两组不良反应发生率、病死率及再住院率差异无统计学意义(均P>0.05)。结论丹参酮Ⅱ A联合左西孟旦可显著改善AHF患者的临床症状,一定程度的逆转左心室肥厚。
Objective To observe the clinical efficacy of tanshinone Ⅱ A combined with levosimendan in the treatment of acute heart failure (AHF). Methods 120 patients with AHF admitted from June 2014 to December 2015 were randomly divided into control group and observation group with 60 cases in each group. The control group was treated with levosimendan injection on the basis of routine treatment for continuous 24 hours. The observation group was given tanshinone Ⅱ A sodium sulfonate injection on the basis of the control group for 7 days. The clinical symptoms, levels of BNP, mean systolic and diastolic blood pressure, mean heart rate, left ventricular ejection fraction (LEVF) and stroke volume (SV), left ventricular end diastolic diameter (LVEDD ), Left ventricular end systolic diameter (LVSDD) and other indicators were compared between the two groups adverse reactions, mortality and re-admission rates. Results After treatment for 24 h, there was significant difference in BNP, mean systolic pressure, diastolic pressure, mean heart rate, SV and LEVF between the two groups (all P> 0.05). There was no significant difference in LVEDD and LVESD between the two groups All P> 0.05). The total effective rate was 83.3% in the observation group and 70.0% in the control group (P <0.05). After 3 months of treatment, the LEVF, LVEDD and LVESD in the observation group were better than those before treatment and after treatment, the difference was statistically significant (P <0.05). There were no significant differences in the incidence of adverse reactions, case fatality and rehospitalization between the two groups (all P> 0.05). Conclusion Tanshinone Ⅱ A combined with levosimendan can significantly improve the clinical symptoms of AHF patients, to a certain extent, reverse the left ventricular hypertrophy.