Comparison of Application of Levosimendan and Nitroglycerin in Coronary Artery Bypass Grafting

YE Xiaoyun; WANG Xidan; LI Rong; WANG Xue; GAO Heng

doi:10.14009/j.issn.1672-2124.2020.11.005

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Comparison of Application of Levosimendan and Nitroglycerin in Coronary Artery Bypass Grafting

更新时间：2022-10-08

- Comparison of Application of Levosimendan and Nitroglycerin in Coronary Artery Bypass Grafting
- Vol. 20, Issue 11, Pages: 1300-1303(2020)
- 作者机构：
  
  1. 西安交通大学医学院第一附属医院药剂科
  2. 西安交通大学医学院第一附属医院心血管外科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2020.11.005
  CLC： R654.2
- Published：2020，
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[1]叶晓云,王喜丹,李蓉,王雪,高珩.左西孟旦与硝酸甘油用于冠状动脉旁路移植术中的对比研究[J].中国医院用药评价与分析,2020,20(11):1300-1303.

YE Xiaoyun, WANG Xidan, LI Rong, et al. Comparison of Application of Levosimendan and Nitroglycerin in Coronary Artery Bypass Grafting. [J]. 20(11):1300-1303(2020)
[1]叶晓云,王喜丹,李蓉,王雪,高珩.左西孟旦与硝酸甘油用于冠状动脉旁路移植术中的对比研究[J].中国医院用药评价与分析,2020,20(11):1300-1303. DOI： 10.14009/j.issn.1672-2124.2020.11.005.

YE Xiaoyun, WANG Xidan, LI Rong, et al. Comparison of Application of Levosimendan and Nitroglycerin in Coronary Artery Bypass Grafting. [J]. 20(11):1300-1303(2020) DOI： 10.14009/j.issn.1672-2124.2020.11.005.

摘要

目的:比较左西孟旦与硝酸甘油对行冠状动脉旁路移植术（coronary artery bypass grafting

CABG）患者临床预后、血液动力学指标和心肌损伤生化标志物的影响。方法:选取2019年3月至2020年2月于西安交通大学医学院第一附属医院进行CABG手术治疗的158例患者

根据随机数字表法将患者分为左西孟旦组（n=79）与硝酸甘油组（n=79）。左西孟旦组、硝酸甘油组患者皮肤切开前分别采用左西孟旦、硝酸甘油进行静脉输注治疗。比较两组患者预后指标、术后不良心血管事件/并发症发生情况的差异。在用药前（T

）

用药6 h（T

）、12 h（T

）和24 h（T

）时检测两组患者的血流动力学指标[心率（HR）、平均动脉压（MAP）、心脏指数（CI）、体循环阻力（SVR）及肺毛细血管楔压（PCWP）]和N末端B型利钠肽原（NT-proBNP）水平。结果:与硝酸甘油组比较

左西孟旦组患者T

（t=8.100

0.001）、T

（t=7.285

0.001）及T

（t=10.799

0.001）时HR水平明显降低

（t=5.266

0.001）、T

（t=8.284

0.001）及T

（t=9.520

0.001）时CI明显升高

（t=4.684

0.001）、T

（t=3.703

0.001）时SVR明显降低;在T

（t=13.996

0.001）、T

（t=11.023

0.001）及T

（t=14.423

0.001）时

左西孟旦组患者NT-proBNP水平均较硝酸甘油组明显降低

上述差异均有统计学意义。左西孟旦组患者机械通气时间（t=8.039

0.001）、ICU住院时间（t=3.909

0.001）较硝酸甘油组明显缩短

差异均有统计学意义。两组患者均无术后不良心血管事件/并发症。结论:早期持续输注左西孟旦可改善行CABG患者的血流动力学指标和NT-proBNP水平

缩短机械通气时间和ICU住院时间。

Abstract

OBJECTIVE: To compare the effects of levosimendan and nitroglycerin on clinical prognosis

hemodynamic parameters and biochemical markers of myocardial injury in patients undergoing coronary artery bypass grafting（ CABG）. METHODS: From Mar. 2019 to Feb. 2020

158 patients with CABG admitted into the First Affiliated Hospital of Xi ’an Jiaotong University were extracted to be divided into the levosimendan group（ n = 79） and the nitroglycerin group（ n = 79） via the random number table. The Levosimendan group and nitroglycerin group were treated with levosimendan and nitroglycerin before skin incision respectively. Differences in prognosis and postoperative adverse cardiovascular events/complications of two groups were compared. Before administration（ T

）

after administration of 6 h（ T

）

12 h（ T

） and 24 h（ T

）

hemodynamic indicators [heart rate（ HR）

mean arterial pressure（ MAP）

cardiac index（ CI）

systemic resistance（ SVR） and pulmonary capillary wedge pressure（ PCWP） ] and N-terminal pro-B-type natriuretic peptide（ NT-pro BNP） of two groups were detected. RESULTS: Compared with the nitroglycerin group

HR rate of the levosimendan group at T

（ t =8. 100

0. 001）

（ t =7. 285

0. 001） and T

（ t =10. 799

0. 001）decreased significantly

CI at T

（ t = 5. 266

0. 001）

（ t = 8. 284

0. 001） and T

（ t =9. 520

0. 001）increased significantly

SVR at T

（ t =4. 684

0. 001） and T

（ t =3. 703

P =0. 001） decreased significantly. At T

（ t =13. 996

0. 001）

（ t = 11. 023

0. 001）

（ t = 14. 423

0. 001）

NT-pro BNP levels in the levosimendan group were significantly lower than those in the nitroglycerin group

with statistically significant differences. The mechanical ventilation time（ t = 8. 039

0. 001） and ICU hospitalization time（ t = 3. 909

0. 001）in the levosimendan group were significantly lower than those in the nitroglycerin group

with statistically significant differences. There were no adverse cardiovascular events/complications in both groups. CONCLUSIONS: Early continuous infusion of levosimendan can improve hemodynamic indicators and NT-pro BNP levels

shorten the mechanical ventilation time and ICU hospitalization time in patients undergoing CABG.

关键词

左西孟旦硝酸甘油冠状动脉旁路移植术

Keywords

LevosimendanNitroglycerinCoronary artery bypass grafting

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