目的 觀察參麥注射液聯(lián)合左西孟旦治療擴(kuò)張型心肌病難治性心力衰竭的臨床療效。方法 選取2013年7月-2015年4月昌江黎族自治縣中西醫(yī)結(jié)合醫(yī)院收治的擴(kuò)張型心肌病難治性心力衰竭患者80例,隨機(jī)分為對(duì)照組和治療組,每組各40例。對(duì)照組給予左西孟旦注射液,初始負(fù)荷劑量12 μg/kg,靜脈注射時(shí)間>10 min,之后用微量泵以0.075 μg/(kg·min)的劑量持續(xù)性的泵入24 h;治療組在對(duì)照組的基礎(chǔ)上靜脈滴注參麥注射液,60 mL溶解于5%葡萄糖溶液150 mL中,1次/d,連續(xù)治療2周。觀察兩組的臨床療效,同時(shí)比較6 min步行實(shí)驗(yàn)(6 MWT)、腦鈉肽(BNP)及心臟功能的變化情況。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為72.50%、92.50%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者6 MWT距離明顯增加,而B(niǎo)NP水平顯著下降,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者的心排血量(CO)、心臟排血指數(shù)(CI)和射血分?jǐn)?shù)(EF)水平均顯著升高,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且這些觀察指標(biāo)的改善程度明顯優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 參麥注射液聯(lián)合左西孟旦治療擴(kuò)張型心肌病難治性心力衰竭具有較好的臨床療效,能夠顯著改心臟功能,提高運(yùn)動(dòng)能力,具有一定的臨床推廣應(yīng)用價(jià)值。

ObjectiveTo observe the clinical effect of Shenmai Injection combined with levosimendan in treatment of dilated cardiomyopathy refractory heart failure. Methods Patients (80 cases) with dilated cardiomyopathy refractory heart failure in Hospital of Integrated Chinese and Western Medicine of Changjiang Li Autonomous County from July 2013 to April 2015 were randomly divided into the control and treatment groups, and each group had 40 cases. Patients in the control group were given Levosimendan Injection, initial loading dose was 12 μg/kg, time of intravenous injection was more than 10 min, then 0.075 μg/(kg·min) was continually pumping for 24 h by micro pump. Patients in the treatment group were iv administered with Shenmai Injection on the basis of the control group, 60 mL added into 5% glucose solution 150 mL, once daily, and treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and 6 MWT, BNP, and cardiac function in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.50% and 92.50%, respectively, and there was difference between two groups (P < 0.05). After treatment, 6 MWT distances in two groups were obviously increased, but BNP levels in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, CO, CI, and EF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Shenmai Injection combined with levosimendan has clinical curative effect in treatment of dilated cardiomyopathy refractory heart failure, and can significantly improve cardiac function, enhance athletic ability, which has a certain clinical application value.