左西孟旦在围产期心肌病患者中的临床疗效和安全性

doi:10.5246/jcps.2023.02.012

中国药学(英文版) ›› 2023, Vol. 32 ›› Issue (2): 138-144.DOI: 10.5246/jcps.2023.02.012

• 【药事管理与临床药学专栏】 • 上一篇下一篇

左西孟旦在围产期心肌病患者中的临床疗效和安全性

许凡凡¹, 巩会平¹^,^*(), 刘增强², 吴倩³

1. 山东大学第二医院急诊医学中心重症监护室, 山东济南 250033
2. 山东大学第二医院干部保健科, 山东济南 250033
3. 溧阳市人民医院肾内科, 江苏溧阳 213399

收稿日期:2022-09-15 修回日期:2022-11-09 接受日期:2022-11-22 出版日期:2023-02-28 发布日期:2023-02-28
通讯作者: 巩会平
作者简介:
+ Tel.: +86-17660080295, E-mail: ghuiping10@163.com
基金资助:
Key R&D Projects in Shandong Province (Grant No. 2017G006029).

Clinical efficacy and safety of levosimendan in patients with peripartum cardiomyopathy

Fanfan Xu¹, Huiping Gong¹^,^*(), Zengqiang Liu², Qian Wu³

1 Department of Emergency, Second Hospital of Shandong University, Jinan 250033, Shandong, China
2 Department of Health, Second Hospital of Shandong University, Jinan 250033, Shandong, China
3 Department of Nephrology, Li yang People’s Hospital, Liyang 213399, Jiangsu, China

Received:2022-09-15 Revised:2022-11-09 Accepted:2022-11-22 Online:2023-02-28 Published:2023-02-28
Contact: Huiping Gong

摘要/Abstract

摘要：

本研究旨在探讨左西孟旦在治疗围产期心肌病患者中的临床疗效和安全性。选择62例围产期心肌病患者作为研究对象。根据药物使用情况分为实验组(n = 30)及对照组(n = 32), 两组均给予常规治疗。实验组在常规治疗的基础上加用左西孟旦12.5 mg, 每周一次。治疗14天后, 观察两组患者治疗前后cTNI、BNP水平及心脏结构和功能变化。同时观察实验组有无不良反应, 如低血压、室性心律失常、过敏等。结果显示, 与对照组相比, 实验组应用左西孟旦后, PPCM患者左室射血分数明显增高, 左心房内径、左室舒张末内径和肺动脉压力均显著减低(P < 0.05)。血清cTNI和BNP均明显下降(P < 0.01)。1例患者出现一过性低血压。研究表明左西孟旦可以明显改善围产期心肌病患者的心功能, 逆转心脏结构重构, 安全性和耐受性良好。

关键词: 左西孟旦, 围产期心肌病, 心脏结构, 心脏功能, B型脑钠肽

Abstract:

In the present study, we aimed to explore the efficacy and safety of levosimendan for patients with peripartum cardiomyopathy (PPCM). Overall, 62 cases with PPCM were selected as the research subjects and randomly divided into an experimental group (30 cases) and a control group (32 cases). The groups differed only in terms of the use of levosimendan. Both groups received conventional therapy. Besides, the experimental group was administered 12.5 mg of levosimendan once a week. The levels of high-sensitivity troponin I (cTnI) and B-type brain natriuretic peptide (BNP) and their cardiac structure and function in the two groups were evaluated before and after treatment. Concurrently, the experimental group was observed for adverse reactions, such as hypotension, ventricular arrhythmia, and allergy. After 14 d of treatment, the experimental group, when compared with the control group, showed significantly increased left ventricular ejection fraction and significantly lower left ventricular internal diameter, left atrial anteroposterior diameter, and pulmonary artery pressure (P < 0.05). Serum cTnI and BNP were also significantly decreased (P < 0.01). Transient hypotension occurred in one patient. Through this study, we concluded that levosimendan could significantly improve cardiac function and reverse cardiac remodeling in patients with PPCM, and this approach had good levels of safety and tolerance.

Key words: Levosimendan, Peripartum cardiomyopathy, Cardiac structure, Cardiac function, BNP

Supporting:

许凡凡, 巩会平, 刘增强, 吴倩. 左西孟旦在围产期心肌病患者中的临床疗效和安全性[J]. 中国药学(英文版), 2023, 32(2): 138-144.

Fanfan Xu, Huiping Gong, Zengqiang Liu, Qian Wu. Clinical efficacy and safety of levosimendan in patients with peripartum cardiomyopathy[J]. Journal of Chinese Pharmaceutical Sciences, 2023, 32(2): 138-144.

图/表 4

Table 1. Comparisons of the experimental and control groups in terms of baseline data.

Table 2. Comparisons of the experimental and control groups in terms of rates of effectiveness after drug treatment.

Table 3. Comparison of echocardiography before and after drug treatment.

Table 4. Inter-group comparison of changes in BNP and cTnI before and after treatment.

参考文献 12

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左西孟旦在围产期心肌病患者中的临床疗效和安全性

Clinical efficacy and safety of levosimendan in patients with peripartum cardiomyopathy

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