Abstract: Objective To investigate the efficacy and safety of levosimendan, dobutamine and milrinone in the treatment of septic myocardial injury. 
Methods In total, 84 patients with septic myocardial injury were selected and divided into levosimendan group, dobutamine group, and milrinone group according to the random number table method, with 28 patients in each group. Total effective rate, soluble myeloid cell trigger receptor-1 (sTREM-1), soluble cluster of differentiation antigen 14 (sCD14), soluble cluster of differentiation antigen 163 (sCD163), cardiac troponin I (cTnI), brain natriupeptide (BNP), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF) and adverse reactions were compared in the three groups. 
Results The total effective rate of levosimendan group was higher than that of dobutamine group and milrinone group (P＜0.05). One-way analysis of variance showed that before treatment, there was no significant difference in sTREM-1, sCD14, sCD163, cTnI, BNP, LVEF, LVEDVI, and LVESVI among three groups (P＞0.05). The comparison of sTREM-1, sCD14, sCD163, cTnI, BNP, LVEF, LVEDVI, and LVESVI was statistically significant among three groups (P＜0.05). Comparison between two groups showed that sTREM-1, sCD14, sCD163, cTnI, BNP, LVEDVI, and LVESVI in levosimendan group were lower than those in dobutamine group and milrinone group, while LVEF was higher than that of dobutamine group and milrinone group (P＜0.05). The total incidence of adverse reactions in levosimendan group and dobutamine group was lower than that in milrinone group (P＜0.05), which, however, were not significantly different between levosimendan group and dobutamine group (P＞0.05). 
Conclusion Levosimendan is more effective than dobutamine and milrinone in the treatment of sepsis myocardial injury, with good safety and no serious adverse reactions.

Key words: cardiomyopathies, sepsis, levosimendan