左西孟旦预处理对急性心肌梗死患者经皮冠状动脉介入治疗后心肌再灌注后左室重构的影响。

Shengqin Yu, Jindong Zhang
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引用次数: 0

摘要

目的:左西孟旦是一种常用于治疗心力衰竭的新型药物。目的探讨左西孟旦预处理对急性心肌梗死(AMI)患者行经皮冠状动脉介入治疗(PCI)后心肌再灌注后左室重构(LVR)的影响。方法将2018年1月~ 2020年9月收治的258例AMI患者随机分为对照组和观察组。在常规药物治疗的基础上,观察组在PCI前30 min给予左西孟旦,对照组静脉注射多巴酚丁胺。比较基线数据、心肌梗死溶栓(TIMI)血流分级、心肌损伤标志物、LVR指标,并分析LVR的影响因素。结果治疗后两组患者均有不同程度的血流灌注,且两组患者的TIMI评分均优于治疗前(P < 0.05)。两组患者的天冬氨酸转氨酶、肌酸激酶- mb、心肌肌钙蛋白T、脑钠肽(BNP)水平均下降,且观察组下降幅度更大(P < 0.05)。两组患者左室收缩末内径、左室舒张末内径、左室舒张末容积均下降,左室射血分数升高,且以观察组明显(P < 0.05)。年龄和BNP是LVR的危险因素,左西孟旦预处理是LVR的保护因素(P < 0.05)。结论左西孟旦预处理具有保护心功能、促进左室结构恢复的作用。年龄和BNP是AMI PCI患者心肌再灌注后LVR的危险因素,左西孟旦预处理是保护因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of Levosimendan Preconditioning on Left Ventricular Remodeling after Myocardial Reperfusion in Acute Myocardial Infarction Patients Receiving Percutaneous Coronary Intervention.
OBJECTIVE Levosimendan is a novel drug often used to treat heart failure. We aimed to explore the effects of levosimendan preconditioning on left ventricular remodeling (LVR) after myocardial reperfusion in acute myocardial infarction (AMI) patients receiving the percutaneous coronary intervention (PCI). METHODS A total of 258 AMI patients treated from January 2018 to September 2020 were randomly divided into control and observation groups. Based on conventional drug therapy, levosimendan was given 30 min before PCI for the observation group, and dobutamine was intravenously injected for the control group. Baseline data, thrombolysis in myocardial infarction (TIMI) blood flow grade, myocardial injury markers, and LVR indices were compared, and the influencing factors for LVR were analyzed. RESULTS After treatment, various degrees of blood perfusion were found, and the TIMI grade was better than that before treatment in both groups (P < .05). The levels of aspartate aminotransferase, creatine kinase-MB, cardiac troponin T, and brain natriuretic peptide (BNP) declined in both groups, more significantly in the observation group (P < .05). Left ventricular end-systolic diameter, left ventricular end-diastolic diameter and left ventricular end-diastolic volume declined, whereas left ventricular ejection fraction rose in both groups, more significantly in the observation group (P < .05). Age and BNP were risk factors for LVR, whereas levosimendan preconditioning was a protective factor (P < .05). CONCLUSION Levosimendan preconditioning can protect cardiac function and promote the recovery of the left ventricular structure. Age and BNP are risk factors for LVR after myocardial reperfusion in AMI patients undergoing PCI, and levosimendan preconditioning is a protective factor.
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