王凤霞, 刘永国, 燕建锋, 查额尔敦巴特, 穆叶赛·尼加提, 李国庆. 左西孟旦和米力农对射血分数减低型心力衰竭患者血流动力学参数影响的比较[J]. 心脏杂志, 2019, 31(6): 677-680, 700. DOI: 10.12125/j.chj.201902022
    引用本文: 王凤霞, 刘永国, 燕建锋, 查额尔敦巴特, 穆叶赛·尼加提, 李国庆. 左西孟旦和米力农对射血分数减低型心力衰竭患者血流动力学参数影响的比较[J]. 心脏杂志, 2019, 31(6): 677-680, 700. DOI: 10.12125/j.chj.201902022
    Feng-xia WANG, Yong-guo LIU, Jian-feng YAN, ChaErdunbate, · nijiati Muyesai, Guo-qing LI. A comparative study of the effects of levosimendan and milrinone on hemodynamics in patients with ejection fraction reduced heart failure[J]. Chinese Heart Journal, 2019, 31(6): 677-680, 700. DOI: 10.12125/j.chj.201902022
    Citation: Feng-xia WANG, Yong-guo LIU, Jian-feng YAN, ChaErdunbate, · nijiati Muyesai, Guo-qing LI. A comparative study of the effects of levosimendan and milrinone on hemodynamics in patients with ejection fraction reduced heart failure[J]. Chinese Heart Journal, 2019, 31(6): 677-680, 700. DOI: 10.12125/j.chj.201902022

    左西孟旦和米力农对射血分数减低型心力衰竭患者血流动力学参数影响的比较

    A comparative study of the effects of levosimendan and milrinone on hemodynamics in patients with ejection fraction reduced heart failure

    • 摘要:
        目的  比较左西孟旦和米力农对射血分数降低型心力衰竭(HFrEF)急性发作时患者血流动力学相关参数的影响。
        方法  选取新疆维吾尔自治区人民医院心内科监护室2017年10月 ~ 2018年11月入住的HFrEF患者122例,随机分为左西孟旦组(66例)和米力农组(56例),在常规心衰指南用药的基础上,使用左西孟旦或米力农的同时采用脉搏指数连续心排出量(Pulse index continuous cardiac output,PICCO)监测在不同时段监测患者心指数(CI)、胸腔内血容量指数(ITBVI)、全心舒张末期容量指数(GEDVI)、血管外肺水指数(EVLWI)等血流动力学参数进行比较分析。
        结果  左西孟旦组和米力农组在年龄、性别、左室射血分数(LVEF)等均衡性检验无统计学差异;在左西孟旦组和米力农组之间0(h)时CI、GEDVI、ITBVI、EVLWI比较均无统计学差异,左西孟旦组CI、GEDVI、ITBVI、EVLWI在0(h)、3(h)、8(h)、24(h)之间两两比较差异具有统计学意义(P < 0.01),米力农组0(h)CI与ITBVI除在0(h)与3(h)两结果相比无统计学意义,CI、GEDVI、ITBVI、EVLWI结果在其余各时间段两两对比均具有统计学意义(P < 0.01);左西孟旦组和米力农组CI、EVLEI在0(h)与3(h)、8(h)、24(h)时差异均无统计学意义,ITBVI、GEDVI除0 h差异无统计学意义外,其余各时间点差异均有统计学意义(P < 0.05,P < 0.01)。
        结论  左西孟旦组与米力农组均可改善血流动力学,不同时间段其改善效果不同,通过PICCO监测可有效评估血流动力学指标变化情况并协助评估临床治疗决策。

       

      Abstract:
        AIM  To compare the effects of levosimendan and milrinone on hemodynamic parameters in patients with acute ejection of fractional heart failure (HFrEF).
        METHODS  A total of 122 patients with HFrEF who were admitted to the Department of Cardiology, People's Hospital of Xinjiang Uygur Autonomous Region from October 2017 to November 2018 were randomly divided into the left Xidandan group (66 cases) and the milrinone group (56 cases). On the basis of the conventional heart failure guidelines, the left heart or the milrinone was used to monitor the heart index (CI) at different time points using Pulse Index Continuous cardiac output (PICCO) monitoring. Hemodynamic parameters such as intrathoracic blood volume index (ITBVI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) were compared and analyzed.
        RESULTS  There was no significant difference in the balance test between age, gender and left ventricular ejection fraction (LVEF) between the left Xidandan group and the milrinone group,0 h between the left Xidandan group and the milrinone group. There were no significant differences in CI, GEDVI, ITBVI, and EVLWI. The left-western group of CI, GEDVI, ITBVI, and EVLWI were at 0 h, 3 h, 8 h, 24 h. The difference between the two groups was statistically significant (P < 0.01). There was no statistically significant difference between the 0 (h) and ITBVI in the milrinone group except 0 h and 3 h), CI, GEDVI, ITBVI, EVLWI results were statistically significant in the other time periods (P < 0.01); left Ximendan group and milrinone group CI, EVLEI at 0 h and There were no significant differences between 3 h, 8 h and 24 h. There was no significant difference in ITBVI and GEDVI except 0 h, and the other time points were statistically significant (P < 0.05, P < 0.01).
        CONCLUSION  Both the levosimendan group and the milrinone group can improve hemodynamics. The improvement effect is different in different time periods. The PICCO monitoring can effectively evaluate the changes of hemodynamic parameters and assist in the evaluation of clinical treatment decisions.

       

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