米力农治疗老年人慢性肺心病心力衰竭50例疗效观察  

Milrinone therapy for heart failure in the elderly with chronic cor pulmonale

作　　者：王以炳[1] 肖莉[1] 刘莉敏[1] 张天民[1] 

机构地区：[1]武汉科技大学附属医院呼吸内科,湖北省武汉市430064

出　　处：《实用老年医学》2007年第6期386-388,共3页Practical Geriatrics

摘　　要：目的观察米力农对老年人慢性肺心病心力衰竭(心衰)的疗效,寻求纠正老年人慢性肺心病心衰的合理用药。方法50例患者为米力农治疗组,在综合治疗的基础上以米力农首剂负荷量50μg/(kg·min),缓慢静注10min,再以0.5μg/(kg·min)静滴,时间4h,每日1次,7d为1疗程;48例患者为对照组,在综合治疗基础上加多巴酚丁胺20～40mg+5%葡萄糖250ml,以2.5μg/(kg·min)静滴,每日1次,7d为1疗程。结果治疗组显效率44%(22/50),有效率52%(26/50),总有效率96%;对照组显效率35.4%(17/48),有效率45.8%(22/48),总有效率81.1%。治疗组疗效明显优于对照组(P<0.01)。结论老年慢性肺心病心衰洋地黄类强心剂不但疗效差,且易导致中毒,选择米力农既可发挥正性肌力作用,又可扩张血管、减轻心脏负荷,疗效肯定、安全。Objective To observe the effect of milrinone on heart failure in the elderly with chronic cor pulmonale. Methods Fifty cases were enrolled in milrinone group. On the basis of comprehensive treatment, the first loading dose of milrinone was 50 μg/（kg · min） ,followed by0.5 μg,/（kg · min） IV drip for 4 h,one time per day. One therapeutic course was 7 d. Control group included 48 cases. In addition to comprehensive therapy, dobutamine 20 - 40 mg plus 5% glucose 250 ml were infused at a dose of 2. 5 μg（kg·min） IV drip , one time per day for 7 d as a therapeutic course. Results In therapeutic group,the excellently effective rate was 44% （22/50） ,the fairly effective rate was 52% （26/50） ,the total improvement rate was 96%. In control group,the excellently effective rate was 35.4% （ 17/48）, the fairly effective rate was 45.8% （22/48） ,the total improvement rate was 81.1%. The improvement rate in therapeutic group was significantly higher than that of control group（P 〈 0. 01 ）. Condusions The therapeutic effect of digitalis cardiac glycosides in treatment of heart failure in the elderly with chronic cor pulmonale is usually unsatisfactory and sometimes it can result in digitalis intoxi- cation. Milrinone not only has the positive inotropic of cardiac muscle,but also can dilate the blood vessels in order to less- en the heart load. Milrinone is safe and effective for heart failure in the elderly with chronic cor pulmonale.

关 键 词：老年人 慢性肺心病 治疗 米力农 

分 类 号：R541.5[医药卫生—心血管疾病] R541.61[医药卫生—内科学]