[1]李明前,杨朝坤,李彦君,等.左西孟旦应用于心脏手术的研究现状[J].医学信息,2024,37(11):184-188.[doi:10.3969/j.issn.1006-1959.2024.11.039]
 LI Ming-qian,YANG Chao-kun,LI Yan-jun,et al.Research Status of Levosimendan in Cardiac Surgery[J].Journal of Medical Information,2024,37(11):184-188.[doi:10.3969/j.issn.1006-1959.2024.11.039]
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左西孟旦应用于心脏手术的研究现状()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年11期
页码:
184-188
栏目:
综述
出版日期:
2024-06-01

文章信息/Info

Title:
Research Status of Levosimendan in Cardiac Surgery
文章编号:
1006-1959(2024)11-0184-05
作者:
李明前杨朝坤李彦君
(1.成都医学院临床医学院,四川 成都 610000;2.宜宾市第二人民医院胸心外科,四川 宜宾 644000)
Author(s):
LI Ming-qianYANG Chao-kunLI Yan-junet al.
(1.School of Clinical Medical,Chengdu Medical College,Chengdu 610000,Sichaun,China;2.Department of Cardio-Thoracic Surgery,the Second People’s Hospital of Yibin,Yibin 644000,Sichuan,China)
关键词:
左西孟旦作用机理心脏手术
Keywords:
LevosimendanMechanism of actionCardiac surgery
分类号:
R654.2
DOI:
10.3969/j.issn.1006-1959.2024.11.039
文献标志码:
A
摘要:
左西孟旦是新一代的正性肌力药物,它避免了传统强心药物增加心肌耗氧量的风险,具有运用于心脏外科手术的巨大潜力。只有部分临床研究证实左西孟旦运用于心脏手术在血流动力学、血液检测指标、住院时间等方面有益处,而在心衰发生率、死亡率等方面的优势并未超越传统正性肌力药物。本文就左西孟旦的作用机理及在心脏外科围手术期不同时间段使用的研究情况进行综述,为其临床应用提供参考。
Abstract:
Levosimendan is a new generation of positive inotropic drug that has great potential for use in cardiac surgery, as it avoids the risk of increased myocardial oxygen consumption associated with traditional cardiac drugs. Only some clinical studies have confirmed the benefits of levosimendan in cardiac surgery in terms of hemodynamics, blood test indexes, and hospital stay, while its advantages in terms of heart failure incidence and mortality have not surpassed those of traditional positive inotropic drugs. This article reviews the mechanism of action of levosimendan and its use in different time periods in the perioperative period of cardiac surgery to provide a reference for its clinical application.

参考文献/References:

[1]Lomivorotov VV,Efremov SM,Kirov MY,et al.Low-Cardiac-Output Syndrome After Cardiac Surgery[J].J Cardiothorac Vasc Anesth,2017,31(1):291-308.[2]Nielsen DV,Hansen MK,Johnsen SP,et al.Health outcomes with and without use of inotropic therapy in cardiac surgery: results of a propensity score-matched analysis[J].Anesthesiology,2014,120(5):1098-1108.[3]Erb J,Beutlhauser T,Feldheiser A,et al.Influence of levosimendan on organ dysfunction in patients with severely reduced left ventricular function undergoing cardiac surgery[J].J Int Med Res,2014,42(3):750-764.[4]Farmakis D,Alvarez J,Gal TB,et al.Levosimendan beyond inotropy and acute heart failure: Evidence of pleiotropic effects on the heart and other organs: An expert panel position paper[J].Int J Cardiol,2016,222:303-312.[5]高鹏,寇广亚,武延海.左西孟旦治疗老年顽固性充血性心力衰竭并肾功能不全的疗效评价[J].实用医学杂志,2016,32(12):2041-2045.[6]李永梅,梅霞,郑向清,等.左西孟旦治疗失代偿心衰合并肾功能不全患者的疗效观察[J].第三军医大学学报,2016,38(8):897-900.[7]Toller W,Heringlake M,Guarracino F,et al.Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion[J].Int J Cardiol,2015,184:323-336.[8]Badalzadeh R,Yavari R,Chalabiani D.Mitochondrial ATP-sensitive K+ channels mediate the antioxidative influence of diosgenin on myocardial reperfusion injury in rat hearts[J].Gen Physiol Biophys,2015,34(3):323-329.[9]Santillo E,Migale M,Massini C,et al.Levosimendan for Perioperative Cardioprotection: Myth or Reality?[J].Curr Cardiol Rev,2018,14(3):142-152.[10]Anastasiadis K,Antonitsis P,Vranis K,et al.Effectiveness of prophylactic levosimendan in patients with impaired left ventricular function undergoing coronary artery bypass grafting: a randomized pilot study[J].Interact Cardiovasc Thorac Surg,2016,23(5):740-747.[11]van Diepen S,Mehta RH,Leimberger JD,et al.Levosimendan in patients with reduced left ventricular function undergoing isolated coronary or valve surgery[J].J Thorac Cardiovasc Surg,2020,159(6):2302-2309.e6.[12]Guerrero-Orriach JL,Ariza-Villanueva D,Florez-Vela A,et al.Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase[J].Ther Clin Risk Manag,2016,12:623-630.[13]张芸楠,贾明,潘昱,等.心脏手术术后发生急性肾损伤的相关因素[J].中华医学杂志,2020,100(12):928-932.[14]Desai PM,Sarkar MS,Umbarkar SR.Prophylactic preoperative levosimendan for off-pump coronary artery bypass grafting in patients with left ventricular dysfunction: Single-centered randomized prospective study[J].Ann Card Anaesth,2018,21(2):123-128.[15]王保申,史坚,张静波,等.预防性应用左西孟旦对左心室功能障碍患者非体外循环冠状动脉旁路移植术后早期心肌功能的影响[J].实用心脑肺血管病杂志,2022,30(1):90-95.[16]生伟,池一凡,牛兆倬,等.OPCABG术前预防性应用左西孟旦治疗低LVEF冠心病63例[J].中华胸心血管外科杂志,2019,35(2):91-93.[17]Hummel J,Rücker G,Stiller B.Prophylactic levosimendan for the prevention of low cardiac output syndrome and mortality in paediatric patients undergoing surgery for congenital heart disease[J].Cochrane Database Syst Rev,2017,3(3):CD011312.[18]Cholley B,Caruba T,Grosjean S,et al.Effect of Levosimendan on Low Cardiac Output Syndrome in Patients With Low Ejection Fraction Undergoing Coronary Artery Bypass Grafting With Cardiopulmonary Bypass: The LICORN Randomized Clinical Trial[J].JAMA,2017,318(6):548-556.[19]Elbadawi A,Elgendy IY,Saad M,et al.Meta-Analysis of Trials on Prophylactic Use of Levosimendan in Patients Undergoing Cardiac Surgery[J].Ann Thorac Surg,2018,105(5):1403-1410.[20]蒙茂龙,王志伟,周楚芝,等.左西孟旦在重症瓣膜病术中缺血预处理中的应用分析[J].临床外科杂志,2019,27(4):352-354.[21]Grieshaber P,Lipp S,Arnold A,et al.Impact of prophylactic administration of Levosimendan on short-term and long-term outcome in high-risk patients with severely reduced left-ventricular ejection fraction undergoing cardiac surgery - a retrospective analysis[J].J Cardiothorac Surg,2016,11(1):162.[22]杨文聪,彭晓鹏,沈国刚,等.外科换瓣术中心脏停搏前灌注左西孟旦心肌缺血预处理的疗效分析[J].中国医刊,2018,53(10):1127-1130.[23]Mehta RH,Leimberger JD,van Diepen S,et al.Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery[J].N Engl J Med,2017,376(21):2032-2042.[24]Thorlacius EM,Vistnes M,Ojala T,et al.Levosimendan Versus Milrinone and Release of Myocardial Biomarkers After Pediatric Cardiac Surgery: Post Hoc Analysis of Clinical Trial Data[J].Pediatr Crit Care Med,2021,22(7):e402-e409.[25]樊国亮,陈铁男,刘志刚,等.左西孟旦在重症冠状动脉旁路移植患者术后的作用研究[J].中华老年医学杂志,2019,38(5):516-519.[26]Baysal A,Yanartas M,Dogukan M,et al.Levosimendan improves renal outcome in cardiac surgery: a randomized trial[J].J Cardiothorac Vasc Anesth,2014,28(3):586-594.[27]胡晓燕,徐秋萍.左西孟旦在心脏外科术后重症患者的应用研究[J].中国临床药理学与治疗学,2020,25(9):1027-1032.[28]Landoni G,Lomivorotov VV,Alvaro G,et al.Levosimendan for Hemodynamic Support after Cardiac Surgery[J].N Engl J Med,2017,376(21):2021-2031.[29]Verma S,Rathwell S,Fremes S,et al.Associated factors and clinical outcomes in mechanical circulatory support use in patients undergoing high risk on-pump cardiac surgery: Insights from the LEVO-CTS trial[J].Am Heart J,2022,248:35-41.[30]Pan KC,Shankar S,Millar J,et al.Role of levosimendan in weaning children requiring veno-arterial extracorporeal membrane oxygenation after cardiac surgery[J].Eur J Cardiothorac Surg,2021,59(1):262-268.[31]Wang A,Cui C,Fan Y,et al.Prophylactic use of levosimendan in pediatric patients undergoing cardiac surgery: a prospective randomized controlled trial[J].Crit Care,2019,23(1):428.[32]Frommeyer G,Kohnke A,Ellermann C,et al.Acute infusion of levosimendan enhances atrial fibrillation in an experimental whole-heart model[J].Int J Cardiol,2017,236:423-426.

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更新日期/Last Update: 1900-01-01