| Objective:Fulminan myocarditis(FM)is one of the most challenging diseases in cardiovascular diseases.This article is to investigate the efficacy of intra-aortic ballon counterpulsation(IABP)combined with levosimendan in the treatment of patients who were attacked by fulminant myocarditis.Methods: A total of 71 patients were choosen for ourstudy,who be diagnosed FM during January 2011 to September 2018 and receive treatment in the First Affiliated Hospital of Nanchang University.Grouped according to the patient’s treatment plan,divided into four groups: conventional drug therapy(group A),conventional drugs combined with levosimendan(group B),conventional drugs and IABP(group C),conventional drugs and IABP combined with levosimendan(group D).Compare the four groups of pre-treatment medical history and vital signs before treatment,such as systolic blood pressure,diastolic blood pressure,heart rate,and blood gas analysis.The peak of laboratory tests after completion,such as NT-ProBNP,muscle Acid phosphokinase isoenzyme(CK-MB),troponin I(cTnI),creatinine,alanine aminotransferase(ALT),etc.;imaging examination:left ventricular ejection fraction(LVEF),III degree room Ventricular conduction block,ventricular tachycardia,ventricular fibrillation,etc.;the time when CK-MB returned to normal after treatment,the difference of LVEF and LVEF after one week of treatment,the in-hospital mortality and hospitalization time of the two groups,Multivariate logistic regression was used to analyze the factors affecting hospitalization outcomes.Result:1.The time of recovery of muscle enzymes in the four groups was different,and there were differences(P<0.05).The use of IABP(group C 、 groupD)can significantly shorten the recovery time of muscle enzymes compared with conventional drugs(AvsC,P=0.001,AvsD,P=0.026),the difference was statistically significant(P<0.05).2.The degree of LVEF increased in the four groups of treatments was different(P<0.05).The use of IABP(group C、groupD)compared with conventional drugs can significantly improve LVEF(AvsC,P=0.004,AvsD,P= 0.001),the difference was statistically significant(P<0.05);IABP alone compared with conventional drugs combined with levosimendan treatment can improve LVEF(CvsB,12.70±7.09vs7.63±3.11,P=0.04)Academic significance;IABP combined with levosimendan treatment significantly increased LVEF(DvsC17.00±4.32vs12.70±7.09,P=0.045)compared with IABP alone,the difference was statistically significant(P<0.05).3.four groups of treatment patients with different hospitalization time(P <0.05),the use of IABP(group C、groupD)compared with conventional drugs can shorten the hospital stay(AvsC,P = 0.027,AvsD,P = 0.001 The difference was statistically significant(P<0.05);IABP combined with levosimendan treatment significantly shortened hospital stay compared with IABP alone(DvsC,12.57±2.37vs14.61±5.10,P=0.021),the difference has Statistical significance(P <0.05).4.The urine volume of the four groups was different after treatment(P<0.05).The use of IABP(group C、groupD)increased the urine volume of patients compared with conventional drugs(AvsC,P=0.017;AvsD,P= 0.010),the difference was statistically significant(P < 0.05).5.The number of deaths in the conventional drug-treated group was 11 and the number of deaths in the IABP-treated group was 2.The mortality rate was lower in the IABP group than in the conventional drug-treated group(P<0.05).Mortality was lower in the Mengdan group than in the conventional drug group,and the difference was statistically significant(P<0.05).Conclusion:Compared with the conventional drug-treated group,the combination of IABP and levosimendan can restore myocardial damage earlier,increase renal perfusion in the acute phase,significantly increase left ventricular ejection fraction,shorten patient hospitalization time,and increase Survival rate of patients in hospital;compared with IABP and levosimendan treatment,combination therapy can significantly improve left ventricular ejection fraction and shorten hospitalization time. |
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