目的 通过与多巴酚丁胺比较，观察小剂量左西孟旦治疗老年重症急性左心衰竭的有效性。方法 对26例老年重症急性左心衰竭患者使用了左西孟旦，25例患者使用多巴酚丁胺作为对照组，观察用药前后生命体征、呼吸困难程度评分、LVEF、SV、BNP和生化指标。结果 两组用药前后生命体征比较，差异无统计学意义；两组用药后24 h呼吸困难程度评分降低，LVEF、SV升高、BNP浓度下降，与用药前比较有统计学差异(P＜0.05)，且实验组显著优于对照组(P＜0.05)；两组停药后24 h各项指标比较差异有统计学意义 (P＜0.05)。结论 对老年重症急性左心衰竭患者推荐使用小剂量左西孟旦。

Objective To compare the efficacy of small dose levosimendan and dobutamine in plderly patient with severe acute left heart failure. Methods Acute left heart failure was treated with levosimendan in 26 elderly patients as trial group, and with dobutamine in 25 elderly patients as control group. Vital signs, dyspnea, LVEF, SV, BNP and blood biochemical index before and after drug administration were observed. Results There were no significant differences in vital signs between the trial group and the control group before and after drug administration（P>0.05）. Decrease of dyspnea, increase of LVEF, SV, and decrease of BNP were significantly different before and after drug administration(P＜0.05), There were significant differences in dyspnea, LVEF, SV and BNP between the trial group and the control group at 24 h after drug administration and termination of drug administration (P＜0.05). Conclusions Small dose levosimendan is recommended for treating elderly patients with severe acute left heart failure.