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目的探讨左西孟旦对老年急性心肌梗死合并心力衰竭患者心功能和炎性反应水平的影响。方法选取2013年2月至2015年10月辽宁省阜新市第二人民医院收治的84例急性心肌梗死合并心力衰竭患者作为研究对象,按随机数字表法将其分为观察组和对照组,各42例。对照组患者给予常规治疗,观察组患者在对照组基础上采用左西孟旦进行治疗。比较两组患者临床疗效、治疗前后心功能及炎性因子水平。结果观察组患者治疗的总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者的左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)均明显低于对照组,左心室射血分数(LVEF)明显高于对照组,差异均有统计学意义(均P<0.05);治疗后,观察组患者血清超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、脑钠肽前体(NT-pro BNP)水平均明显低于对照组,差异均有统计学意义(均P<0.05)。结论采用左西孟旦治疗心肌梗死合并心力衰竭临床疗效显著,可有效改善患者心功能,降低炎性因子水平,增强心肌收缩,稳定血流动力学。
Objective To investigate the effect of levosimendan on cardiac function and inflammatory response in elderly patients with acute myocardial infarction complicated with heart failure. Methods From February 2013 to October 2015, 84 patients with acute myocardial infarction complicated with heart failure admitted to the Second People’s Hospital of Fuxin City, Liaoning Province were selected as subjects and divided into observation group and control group according to random number table 42 cases. Patients in the control group were given routine treatment. Patients in the observation group were treated with levosimendan on the basis of the control group. The clinical efficacy, heart function and inflammatory cytokines levels before and after treatment were compared between the two groups. Results The total effective rate of observation group was significantly higher than that of control group (P <0.05). After treatment, LVESD, LVEDD, (P <0.05). After treatment, the serum levels of hs-CRP (hs-CRP) in the observation group were significantly lower than those in the control group, and the left ventricular ejection fraction (LVEF) in the observation group was significantly higher than that in the control group ), IL-6, TNF-α and NT-pro BNP were significantly lower than those in the control group (both were statistically significant (both P <0.05). Conclusion The clinical efficacy of levosimendan in the treatment of myocardial infarction complicated with heart failure is significant, which can effectively improve the cardiac function, reduce the levels of inflammatory cytokines and enhance myocardial contractility and stabilize hemodynamics.