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.