吸入左西孟旦在肺动脉高压合并右心衰中的应用

doi:10.12092/j.issn.1009-2501.2025.08.017

中国临床药理学与治疗学 ›› 2025, Vol. 30 ›› Issue (8): 1147-1152.doi: 10.12092/j.issn.1009-2501.2025.08.017

• 综述与讲座 • 上一篇

吸入左西孟旦在肺动脉高压合并右心衰中的应用

刘婉玉¹, 孙同文², 毛峥嵘¹

¹河南中医药大学第一附属医院急诊科,河南中医药大学第一附属医院急危重症医学部,郑州 450000,河南;
²郑州大学第一附属医院急诊医学部,郑州 450000,河南

收稿日期:2024-09-20 修回日期:2024-11-12 出版日期:2025-08-26 发布日期:2025-08-12
通讯作者: 毛峥嵘,男,博士,主任医师,硕士生导师,研究方向：急危重症。E-mail： maozhengrong@126.com
作者简介:刘婉玉,女,硕士研究生, 研究方向：急危重症。E-mail： liuwanyu06@163.com
基金资助:
国家自然科学基金（82172129）

Application of inhaled levosimendan in pulmonary hypertension complicated with right heart failure

LIU Wanyu, SUN Tongwen, MAO Zhengrong

¹Emergency Department, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan, China; Emergency and Critical Care Medicine Department, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan, China;
²Emergency Medicine Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China

Received:2024-09-20 Revised:2024-11-12 Online:2025-08-26 Published:2025-08-12

摘要/Abstract

摘要： 肺动脉高压（pulmonary hypertension,PH）是一种严重疾病,其特征是肺动脉压力（pulmonary arterial pressure,PAP）异常增高,导致心脏负担加重,最终可能引起右心衰。左西孟旦作为钙离子增敏剂,具备提升心脏收缩力和促进血管扩张的双重作用。其通过减轻PAP、增加右心室（right ventricle,RV）收缩力、减轻心脏前后负荷而不增加心肌耗氧量,在PH合并右心衰治疗中展现出良好的前景。由于其不会增加细胞内Ca²⁺浓度,避免了其他正性肌力药物致心律失常、冠状动脉灌注减少等副作用。目前左西孟旦主要通过静脉途径输注,这可能导致全身低血压、心律失常等副作用,而吸入给药可降低不良反应的发生,但其在PH合并右心衰治疗中的有效性和安全性仍有待研究。本综述旨在探讨吸入左西孟旦在PH合并右心衰中的作用。

关键词: 肺动脉高压, 右心衰, 吸入左西孟旦, 有效性, 安全性

Abstract: Pulmonary hypertension (PH) is a serious disease characterized by abnormally high pulmonary arterial pressure (PAP), which leads to increased cardiac burden and may eventually lead to right heart failure. Levosimendan, as a calcium sensitizer, has the dual role of enhancing cardiac constriction force and promoting vascular dilation. It shows a good prospect in the treatment of PH combined with right heart failure by reducing PAP, increasing RV contractile force and reducing anterior and posterior cardiac load without increasing myocardial oxygen consumption. Since it does not increase the intracellular Ca²⁺ concentration, it avoids the arrhythmia-inducing, reduced coronary perfusion and other side effects of other positive inotropic drugs. At present, levosimandan is mainly transfused intravenically, which may lead to systemic hypotension, arrhythmia and other side effects, while inhalation administration can reduce the occurrence of adverse reactions, but its effectiveness and safety in the treatment of PH combined with right heart failure remains to be studied. The purpose of this review was to investigate the role of inhaled levosimendan in PH combined with right heart failure.

Key words: pulmonary hypertension, right heart failure, inhaled levosimendan, efficacy, safety

中图分类号:

R543.2

刘婉玉, 孙同文, 毛峥嵘. 吸入左西孟旦在肺动脉高压合并右心衰中的应用[J]. 中国临床药理学与治疗学, 2025, 30(8): 1147-1152.

LIU Wanyu, SUN Tongwen, MAO Zhengrong. Application of inhaled levosimendan in pulmonary hypertension complicated with right heart failure[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2025, 30(8): 1147-1152.

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吸入左西孟旦在肺动脉高压合并右心衰中的应用

Application of inhaled levosimendan in pulmonary hypertension complicated with right heart failure

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