首页|左西孟旦联合多巴酚丁胺治疗老年急性心肌梗死合并心源性休克的效果

左西孟旦联合多巴酚丁胺治疗老年急性心肌梗死合并心源性休克的效果

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目的:研究左西孟旦联合多巴酚丁胺治疗老年急性心肌梗死合并心源性休克中的价值.方法:选择本院 2020年4月—2021年6月收治的老年急性心肌梗死合并心源性休克患者88例,按随机数字表法分成研究组和对照组,各44例.研究组予以左西孟旦联合多巴酚丁胺治疗,而对照组仅予以多巴酚丁胺治疗,比较两组用药前后乳酸、氧分压、中心静脉血氧饱和度(ScvO2)、尿量、乳酸清除率、氧合指数(OI)、每搏量、射血分数(LVEF)、中心静脉压(CVP)、心率、左室舒张末期容积(LVEDV)、氨基末端B型利钠肽前体(NT-proBNP)及去甲肾上腺素使用量、多巴酚丁胺使用量、休克时长、ICU时长、主动脉内球囊反搏使用时长.结果:用药后,研究组乳酸低于对照组,但氧分压、ScvO2、尿量、乳酸清除率、OI均高出对照组(P<0.05).研究组去甲肾上腺素使用量、多巴酚丁胺使用量、休克时长、ICU时长、主动脉内球囊反搏使用时长均低于对照组(P<0.05).研究组每搏量、LVEF高出对照组,但CVP、心率、LVEDV、NT-proBNP低于对照组(P<0.05).结论:左西孟旦联合多巴酚丁胺治疗老年急性心肌梗死合并心源性休克患者的效果确切,可促进血流动力学和组织灌注代谢改善,缩短治疗时长,增强心功能,值得临床应用.
Effect of Levosimendan Combined with Dobutamine in the Treatment of Elderly Patients with Acute Myocardial Infarction Complicated with Cardiogenic Shock
Objective:To study the value of levosimendan combined with dobutamine in the treatment of elderly patients with acute myocardial infarction complicated with cardiogenic shock.Methods:A total of 88 elderly patients with acute myocardial infarction complicated with cardiogenic shock admitted to our hospital from April 2020 to June 2021 were selected and divided into study group and control group according to the random number table method,44 cases in each group.The study group was treated with levosimendan combined with dobutamine,while the control group was only treated with dobutamine.The lactic acid,oxygen partial pressure,central venous oxygen saturation(ScvO2),urine volume,lactic acid clearance rate,oxygenation index(OI),stroke volume,ejection fraction(LVEF),central venous pressure(CVP),heart rate,left ventricular end-diastolic volume(LVEDV),amino-terminal B-type natriuretic peptide precursor(NT-proBNP)and norepinephrine usage,dobutamine usage,shock duration,ICU duration,and intra-aortic balloon counterpulsation duration were compared between the two groups before and after medication.Results:After medication,the lactic acid in the study group was lower than that in the control group,but the oxygen partial pressure,ScvO2,urine volume,lactic acid clearance rate and OI were higher than those in the control group(P<0.05).The norepinephrine dosage,dobutamine dosage,shock duration,ICU duration and intra-aortic balloon counterpulsation duration in the study group were lower than those in the control group(P<0.05).The stroke volume and LVEF of the study group were higher than those of the control group,but the CVP,heart rate,LVEDV and NT-proBNP were lower than those of the control group(P<0.05).Conclusion:Levosimendan combined with dobutamine is effective in the treatment of elderly patients with acute myocardial infarction complicated with cardiogenic shock,which can promote the improvement of hemodynamics and tissue perfusion metabolism,shorten the treatment time and enhance cardiac function.It is worthy of clinical application.

Cardiogenic shockLevosimendanAcute myocardial infarctionDobutamine

陈涛、谢云志

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河南电力医院老年病科,河南 郑州 450000

心源性休克 左西孟旦 急性心肌梗死 多巴酚丁胺

2024

中国药物滥用防治杂志
中国药物滥用防治协会 军事医学科学院毒物药物研究所

中国药物滥用防治杂志

影响因子:0.584
ISSN:1006-902X
年,卷(期):2024.30(3)
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