关键词: 左西孟旦, 心脏外科, 心功能, 肾功能, 肺动脉高压 

Abstract: AIM: To explore the influence of levosimendan on cardiac function, pulmonary hypertensions, renal function of the patients after severe heart surgery. METHODS: A total of 320 cases of patients with severe disease who underwent surgery in cardiac surgery department in our hospital from January 2014 to June 2019 were selected and divided into experiment group and control group using random number table method, 160 cases in each group. The prosthetic heart valve replacement or non-extracorporeal bypass surgery were underwent based on the specific condition of patient, the experiment group received levosimendan during the perioperation at the same time. The changes of cardiac, renal function parameters and pulmonary artery systolic pressure (PASP) at different times before and after operation were compared between the 2 groups. RESULTS: There was no significant difference in HR, MAP and CVP between the two groups 24 h after operation. LAC of the experimental group was significantly lower than that of the control group 12 h and 24 h after operation (P<0.05 or P<0.01). LVEDV and LVESV of the 2 groups showed a decreasing trend from 1 to 14 days after operation (P<0.05 or P<0.01), and the experiment group was significantly less than the control group at the same time point (P<0.05 or P<0.01); the CI and LVEF of the 2 groups showed an increasing trend (P<0.05 or P<0.01), and the experiment group was significantly higher than the control group at the same time point (P<0.05 or P<0.01). The levels of plasma NT-proBNP and PASP showed a decreasing trend of the 2 groups from 3 to 14 days after operation, and the experiment group was significantly lower than the control group at the same time point (P<0.05 or P<0.01); the levels of serum BUN, 24Upro and Scr had no significant change in the experiment (P>0.05), the levels of serum BUN, 24Upro and Scr increased first and then decreased in the control group, and the experiment group was significantly lower than the control group at the same time point (P<0.05 or P<0.01). Compared with the control group, the postoperative mortality, ICU stay, ventilator and IABP support time in the experimental group were significantly lower than those in the control group (P<0.05). CONCLUSION: Levosimendan after cardiac surgery can effectively improve the postoperative cardiac function of severe patients, protect renal injury caused by low perfusion, and reduce the incidence of early postoperative pulmonary hypertension, which is worthy of clinical reference.

Key words: levosimendan, cardiac surgery, cardiac function, renal function, pulmonary hypertension