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《The Chinese Journal of Clinical Pharmacology》 2017-16
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Clinical trial of levosimendan in the treatment of chronic obstructive pulmonary disease with cardiac insufficiency

OU Wei-gen;CAI Hong-liu;Department of Emergency and Intensive Care Unit,First People's Hospital of Yuhang District,Hangzhou;Department of Intensive Care Unit, The First Affiliated Hospital of Zhejiang University Medical College;  
Objective To observe the clinical efficacy and safety of levosimendan combined with terbutaline sulfate in the treatment of chronic obstructive pulmonary disease with cardiac insufficiency. Methods A total of 88 patients were randomly divided into control group and treatment group,with 44 cases in each group. Patients in both groups were given conventional treatment and symptomatic treatment. Patients in control group were given inhalation budesonide suspension liquid 1 mg +terbutaline sulfate atomized liquid 5 mg in jet atomizer,oxygen driven atomization inhalation,twice a day. Patients in treatment group were given levosimendan 0. 1 μg·kg~(-1)·min~(-1)infusion,continue medication24 h on the basis of control group. All patients were treated for 7 d. The clinical efficacy,troponin T,myocardial enzyme spectrum,cardio-pulmonary function and adverse drug reactions in two groups were observed. Results After treatment,the total effective rates in treatment group and control group were 88. 64%( 39/44 cases),70. 45%( 31/44cases),with significant difference( P 0. 05). The levels of troponin T,creatine kinase,creatine kinase isoenzyme,lactate dehydrogenase,left ventricular end diastolic diameter,forced expiratory volume in one second,forced expiratory volume in one second/forced vital capacity( FEV1/FVC),left ventricular ejection fraction,maximum walking distance within 6 min in control group were( 0. 48 ± 0. 06) μg·L~(-1),( 189. 29 ± 21. 30) U·L~(-1),( 11. 34 ± 1. 71)U·L~(-1),( 159. 29 ± 17. 11) U · L~(-1),( 50. 29 ± 5. 79) mm,( 1. 35 ± 0. 19) L,( 60. 93 ± 7. 09) %,( 42. 39 ± 4. 58) %,( 260. 39 ± 29. 21) m,had significant difference with those in treatment group,which were( 0. 18 ± 0. 03) μg· L~(-1),( 130. 27 ± 16. 11) U · L~(-1),( 8. 87 ± 1. 09) U · L~(-1),( 138. 70 ± 14. 51) U · L~(-1),( 47. 01 ± 5. 01) mm,( 1. 70 ± 0. 23) L,( 76. 94 ± 8. 58) %,( 51. 29 ± 5. 71) %,( 324. 29 ± 35. 16) m( P 0. 05).The adverse drug reactions in treatment group were palpitations,headache,dizziness,total incidence rate of adverse drug reactions was 6. 82%( 3/44 cases). The adverse drug reactions in control group were orthostatic hypotension,hyponatremia,arrhythmia,thirst,total incidence rate was 11. 36%( 5/44 cases),with no significant difference( P 0. 05). Conclusion Levosimendan combined with terbutaline sulfate in the treatment of chronic obstructive pulmonary disease with cardiac insufficiency has a higher clinical efficacy,with high safety.
【Key Words】: levosimendan terbutaline sulfate chronic obstructive pulmonary disease cardiac insufficiency
【Fund】: 杭州市余杭区医疗卫生科研重点学科建设基金资助项目(医疗卫生2013-003)
【CateGory Index】: R541;R563.9
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