[1]王文艳 李晓东 伍鑫 袁小媚 孔洪.间断重复使用左西孟旦在不同肾小球滤过率的进展期心力衰竭中的作用比较[J].心血管病学进展,2020,(1):98-102.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.026]
　WANG WenyanLI Xiaodong,WU Xin,YUAN Xiaomei,et al.Effect of Intermediate Repetitive Levosimendan Treatment in Patients with Advanced Heart Failure of Different eGFR[J].Advances in Cardiovascular Diseases,2020,(1):98-102.[doi:10.16806/j.cnki.issn.1004-3934.2020.01.026]
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间断重复使用左西孟旦在不同肾小球滤过率的进展期心力衰竭中的作用比较()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年1期
页码:
98-102
栏目:
论著
出版日期:
2020-02-04

文章信息/Info

Title:
Effect of Intermediate Repetitive Levosimendan Treatment in Patients with Advanced Heart Failure of Different eGFR
作者:
王文艳 李晓东 伍鑫 袁小媚 孔洪
(四川省医学科学院 四川省人民医院 电子科技大学附属医院四川 成都 610072)
Author(s):
WANG WenyanLI Xiaodong;  WU Xin;  YUAN Xiaomei;  KONG Hong
(Heart failure Center, Sichuan Provincial Peoples Hospital, Sichuan Academy of Medical Science, The Affiliated Hospital of University of Electronic Science and Technology of China, Chengdu 610072,Sichuan ,China)
关键词:
射血分数降低性心力衰竭; 肾小球滤过率估算值左西孟旦; 脑钠肽; 再入院率
Keywords:
Heart failure with reduced ejection fraction;  Estimated glomerular filtration rate;  Levosimendan;  Brain natriuretic peptide;  Readmission rate
DOI:
10.16806/j.cnki.issn.1004-3934.2020.01.026
摘要:
目的 探讨不同肾小球滤过率的进展期心力衰竭间断重复使用左西孟旦的疗效差异。方法 纳入住院的进展期射血分数降心力衰竭患者，分为常规治疗组和左西孟旦组，随访观察6个月，按照肾小球滤过率（eGFR）分为eGFR60 mL/(min·1.73 m2)和＜60/(min·1.73 m2)，分别评估治疗前后eGFR脑钠肽（BNP）、左室射血分数（LVEF的变化，非计划再入院率和住院时间。结果 共有177例射血，常规治疗组118例，左西孟旦组59例；两组性别、年龄、肌酐、eGFR、BNP、LVEF及NYHA心功能分级等无差异（P＞0.05）。左西孟旦组基线时收缩压偏111.86±22.59）mm Hg（1 mm Hg=0.133 3 kPa）vs（124.36±22.59）mm Hg，P＜0.001。两组无论基线eGFR水平，治疗后eGFR增加30%的比例无差异23.96% vs 23.92%，P=0.691）；左西孟旦组的非计划再入院率于常规治疗组（80.56% 100%，P＜0.008；非计划再入院住院时间于7 的比例于常规治疗组（61.11% 96.97%，P＜0.001；BNP下降超过30%的比例显著于常规治疗组84.75% vs 27.97%，P＜0.061，LVEF恢复到40%以上的比例于常规治疗组（36.00% vs 28.44%）。上述差异在eGFR＜60/(min·1.73 m2)的患者中显著。结论 间断重复使用左西孟旦治疗进展期心力衰竭eGFR＜60/(min·1.73 m2)的患者，相对于常规治疗组减少患者的非计划再入院，缩短非计划再住院时间，BNP水平下降以及LVEF恢复更加明显。
Abstract:
Objective To investigate the effect of intermittent repetitive application of levosimendan in advanced heart failure subjects with different estimated glomerular filtration rate(eGFR) level. Methods Subjects with HFrEF hospitalized in our Heart Failure Center were included and divided into the control and levosimendan group(Levo group), and both groups were followed up for 6 months. Patients were divided into two groups according to eGFR level[eGFR≥60 mL/(min·1.73 m2) or＜60/(min·1.73 m2)]. The change of eGFR, BNP, body weight between baseline and the follow up, and non-planned hospitalization rate and the length of stay were compared between the two groups. Results A total of 177 HFrEF patients(118 in control group, 59 in Levo group) were included. Significant lower systolic blood pressure(SBP) at baseline was observed in the Levo group [(111.86±22.59) mm Hg vs (124.36±22.59) mm Hg, P＜0.001. Parameters like gender, age, creatinine, eGFR, DBP, BNP, LVEF and NYHA classification were of no difference(P＞0.05. Significant difference were noticed in patients with eGFR＜60/(min·1.73 m2) as the unplanned hospitalization rate (80.56% vs 100%, P＜0.008 and the proportion of the over 7-day unplanned hospitalization(61.11% vs 96.97%,P＜0.001）were lower in the Levo group, while the proportion of the over 30% BNP decreasing (84.75% vs 72.03%,P=0.061) and the proportion of LVEF recovering back to 40% or higher(36.00% vs 28.44, P=0.031) were significantly higher in the Levo group. Conclusion Intermittent repetitive application of levosimendan in advanced heart failure subjects with eGFR＜60/(min·1.73 m2) significantly reduce the unplanned hospitalization rate and BNP level, shorten length of stay, increase LVEF compared with the routine therapy.

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备注/Memo

备注/Memo:
基金项目：四川省科学技术厅国际合作项目（2017HH0107）通讯作者：王文艳，E-mail：ddmm611@163.com
收稿日期：2019-07-23
更新日期/Last Update: 2020-03-24