目的 探討左西孟旦、米力農(nóng)以及多巴酚丁胺治療急性失代償心力衰竭患者的臨床療效及安全性。方法 收取2013年4月-2016年4月間西安市中心醫(yī)院收治的急性失代償心力衰竭患者336例作為研究對象，根據(jù)入院先后順序依次進入A、B、C組，每組各112例，分別給予左西孟旦、米力農(nóng)和多巴酚丁胺進行治療。對3組患者臨床療效、血流動力學、血清學指標以及安全性進行觀察與比較。結(jié)果 A組總有效率（90.18%）明顯高于B組（58.93%）及C組（65.18%），差異有統(tǒng)計學意義（P<0.05）。治療后3組患者肺毛細血管楔壓（PCWP）、肺動脈平均壓（PAMP）、右房壓（RAP）及周圍血管阻力（SVR）均較治療前顯著下降，差異有統(tǒng)計學意義（P<0.05），A組PCWP、PAMP及SVR明顯低于B組及C組（P<0.05）。3組治療后RAP差異不顯著。治療后3組患者氨基末端B型利鈉肽原（NT-proBNP）、內(nèi)皮素-1（ET-1）以及去甲腎上腺素（NE）水平均較治療前明顯下降（P<0.05）；A組顯著低于B組及C組（P<0.05）。A組不良反應發(fā)生率明顯低于B組及C組，差異有統(tǒng)計學意義（P<0.05）。結(jié)論 左西孟旦治療急性失代償心力衰竭療效及安全性均顯著優(yōu)于米力農(nóng)及多巴酚丁胺，值得臨床推廣應用。

Objective To explore the clinical effect and safety of levosimendan, milrinone, and dobutamine in treatment of patients with ADHF. Methods All 336 patients with ADHF accepted in Xi'an Center Hospital from April 2013 to April 2016 were selected and divided into group A, B, and C with 112 cases in each group. Patients in three groups were given levosimendan, milrinone, and dobutamine respectively. Then the clinical effect, hemodynamics, serum indexes, and safety of two groups were observed and compared. Results The total efficacy of group A (90.18%) was obviously higher than group B (58.93%) and group C (65.18%) with statistically significance (P<0.05). PCWP, PAMP, RAP, and SVR of three groups after treatment were lower than before (P<0.05). And PCWP, PAMP, and SVR of group A were obviously lower than those of group B and C (P<0.05). RAP among three groups after treatment had no difference. NT-proBNP, ET-1, and NE of three groups after treatment were lower than before (P<0.05), and group A was obviously lower than group B and C (P<0.05). Adverse reaction rate of group A was obviously lower than that of group B and C with statistically difference (P<0.05). Conclusion Levosimendan has better effect and safety than milrinone and dobutamine in treatment of patients with ADHF, which is worth clinical application.