The Clinical Effect Observation Of Levosimendan Combined With Recombinant Human Brain Natriuretic Peptide In The Treatment Of Acute Heart Failure

Objective: It is to observe the clinical effect and safety of levosimendan combined with recombinant human brain natriuretic peptide in the treatment of acute heart failure.Research Methods: From October,2016 to November,2017,80 patients with acute heart failures were selected as the research objects,which were randomly divided into four groups: group A,group B,group C,and group D according to the method of lot-drawing.Each group owned 20 patients.Group A received the routine treatment.On this basis,levsimendan was added for the treatment of group B;recombinant human Brain Natriuretic Peptide(rhBNP)was added for the treatment of Group C;the levsimendan plus recombinant human Brain Natriuretic Peptide(rhBNP)was added for the joint treatment of Group D.The disease histories of all patients with heart failures were collected after their admission to hospital.During the treatment,the continuous ECG,blood pressure,respiratory frequency,and blood-oxygen saturation were monitored.During the two time points,before the treatment and 72 hours after treatment,a series of research were implemented as follows: to evaluate the degree of dyspnea and conduct NYHA cardiac function grading,to measure the Left Ventricular Ejection Fraction(LVEF)as well as the Left Ventricular End-Diastolic Diameter(LVEDD),to record 24 hours urine volume,to detect NT-proBNP as well as the blood routine test,liver function,renal function,and other indicators,and to observe and record various adverse reactions of the patients from the two groups.Results: After 72 hours of treatment,the heart rate,respiration,and the systolic blood pressure in the four groups were all decreased compared with the former group(P< 0.05);the urine volume in 24 hours increased than before(P < 0.05).The range of change in group B,C,and D was better than that in group A.The difference was statistically significant(P < 0.05);there was no statistic significance in difference comparison among the three groups(P > 0.05).After treatment,the clinical effective rate of group A was 64% and that of group B was 70%,group C 72%,and group D 84%.Group D was significantly better than the other three groups,and the difference wasstatistically significant(P < 0.05);After the treatment,the NT-proBNP of all four groups were decreased(P<0.05),in which Group B,Group C,and Group D was lower than that of group A and the difference was statistically significant(P < 0.05).In addition,Group D was lower than Group B and the difference was statistically significant(P <0.05);Group D was lower than Group C,but the difference was not statistically significant(P>0.05);After the treatment,all the LVEF values of group four groups were increased.The three groups of Group B,Group C,and Group D were all significantly higher than those of group A,and the difference was statistically significant(P < 0.05).In addition,Group D was higher than Group C(P < 0.05)and the difference was statistically significant(P < 0.05);Group D was higher than Group B,but the difference was not statistically significant(P>0.05);After the treatments,the LVEDDs of the four groups were all decreased,but there was no significant difference in Intra-group and inter-group comparisons(P > 0.05);There was no statistically significant difference in the occurrence of adverse events among the four groups(P > 0.05).Conclusion: Levosimendan combined with recombinant human-brain natriuretic peptide can significantly improve the clinical symptoms as well as the cardiac function condition of patients with acute heart failure,make the patients’ heart rate,respiration,and blood pressure stable,increase 24 h urine volume,decrease NT-proBNP,and increase the LVEF value.In addition,it does not increase the adverse reactions and has no effect on liver and kidney function.