目的 探討左西孟旦注射液治療心肌梗死后心源性休克的臨床療效。方法 選取2015年1月—2016年7月在秦皇島市第一醫(yī)院心血管內(nèi)科治療的急性心肌梗死后心源性休克患者60例，按照數(shù)字隨機法將所有患者隨機分為對照組和治療組，每組各30例。對照組靜脈泵注鹽酸多巴酚丁胺注射液，初始劑量2 μg/（kg·min），1 h后增至4 μg/（kg·min），持續(xù)給藥24 h。治療組靜脈泵注左西孟旦注射液，初始劑量12 μg/（kg·min），1 h后劑量調(diào)整為0.5 μg/（kg·min），持續(xù)給藥24 h。兩組患者均治療7 d。觀察兩組的臨床療效，比較兩組的心功能、高敏C反應蛋白（hs-CRP）、白細胞介素-8（IL-8）、腫瘤壞死因子α（TNF-α）和N-末端腦鈉肽前體（NT-proBNP），以及胸痛發(fā)作12、36 h的血清肌酸激酶同工酶（CK-MB）和肌鈣蛋白I（cTNI）的情況。結(jié)果 治療后，對照組和治療組的總有效率分別為73.33%、93.33%，兩組比較差異有統(tǒng)計學意義（P< 0.05）。治療后，兩組左室收縮末期內(nèi)徑（LVESD）和左室舒張末期內(nèi)徑（LVEDD）均顯著降低，而左室射血分數(shù)（LVEF）均顯著升高，同組治療前后比較差異有統(tǒng)計學意義（P< 0.05）；且治療組這些觀察指標的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。治療后，兩組hs-CRP、IL-8、TNF-α和NT-proBNP水平均顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P< 0.05）；且治療組這些觀察指標明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。胸痛發(fā)作36 h，兩組CK-MB和cTNI均顯著低于胸痛發(fā)作12 h，同組比較差異有統(tǒng)計學意義（P< 0.05）；且治療組這些觀察指標明顯低于對照組，兩組比較差異具有統(tǒng)計學意義（P< 0.05）。結(jié)論 左西孟旦注射液治療心肌梗死后心源性休克具有較好的臨床療效，能改善心功能，調(diào)節(jié)hs-CRP、IL-8、TNF-α和NT-proBNP水平，具有一定的臨床推廣應用價值。

Objective To evaluate the clinical effect of Levosimendan Injection in treatment of cardiogenic shock after myocardial infarction. Methods Patients (60 cases) with cardiogenic shock after myocardial infarction in Department of Cardiovascular Medicine of First Hospital of Qinhuangdao from January 2015 to July 2016 were randomly divided into control and treatment groups, and each group had 30 cases. Patients in the control group were intravenous pump injection administered with Dobutamine Hydrochloride Injection, initial dosage was 2 μg/(kg·min), increased to 4 μg/(kg·min) after 1 h, continued administration of 24 h. Patients in the treatment group were intravenous pump injection administered with Levosimendan Injection, initial dosage was 12 μg/(kg·min), adjusted to 0.5 μg/(kg·min) after 1 h, continued administration of 24 h. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and heart function, hs-CRP, IL-8, TNF-α, NT-proBNP, and the levels of serum CK-MB and cTNI at 12 and 36 h after chest pain attack in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 73.33% and 93.33%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVESD and LVEDD in two groups were significantly decreased, but the LVEF 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). After treatment, the levels of hs-CRP, IL-8, TNF-α, and NT-proBNP 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 lower than those in the control group, with significant difference between two groups (P < 0.05). The levels of serum CK-MB and cTNI at 36 h after chest pain attack in two groups were lower than those at 12 h after chest pain attack in two groups, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Levosimendan Injection has clinical curative effect in treatment of cardiogenic shock after myocardial infarction, can improve heart function, and regulate levels of hs-CRP, IL-8, TNF-α, and NT-proBNP, which has a certain clinical application value.