米力农治疗婴幼儿先天性心脏病并肺动脉高压的疗效观察  

Clinical Curative Effect of Using Milrinone Treatment on Pulmonary Artery Hypertension Induced by Congenital Heart Disease in Children

作　　者：王耀菊[1] 陶艳玲[1] 赵毅兰[1] 甄红[1] 

机构地区：[1]广西壮族自治区人民医院儿科,南宁530021

出　　处：《实用儿科临床杂志》2008年第13期1027-1029,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨米力农治疗婴幼儿先天性心脏病(CHD)并肺动脉高压(PAH)的临床疗效及血流动力学、心功能指标的变化和意义。方法选择广西壮族自治区人民医院2004年7月-2007年7月收治的45例婴幼儿CHD并PAH患儿。随机分为米力农治疗组(米力农组,n=25)及多巴胺加酚妥拉明治疗组(多巴胺组,n=20)。米力农组予米力农0.5μg/(kg.min);多巴胺组予多巴胺和酚妥拉明,均为5μg/(kg·min)。二组均持续静脉给药5d,观察临床疗效、血流动力学和心功能指标变化,并进行比较。结果米力农组用药后5d,患儿临床症状、体征好转,血流动力学及心功能指标较治疗前显著改善(Pa<0.05),总有效率为92.0%;多巴胺组治疗前后血流动力学及心功能指标改善不明显(Pa>0.05),总有效率为75.0%。米多农组与多巴胺组治疗后临床疗效、血流动力学和心功能指标比较差异均有统计学意义(Pa<0.05)。米力农组患儿心率、血压较治疗前均无显著变化(Pa>0.05),无严重心律失常发生。结论米力农具有正性肌力和扩血管的作用,对肺血管床有选择性扩张作用,能明显改善CHD婴幼儿并PAH的心功能,降低其肺动脉压力,不影响其血压和心率,其临床疗效优于多巴胺。Objective To investigate the clinical curative effect of using milfinone on treating children pulmonary artery hypertension （PAH） induced by congenital heart disease （CHD） and changes of hemodynamies and heart function. Methods A total of 45 children with PAH induced by CHD from the People＇s Hospital of Guangxi Zhuang Autonomous Region were randomly divided into 2 groups. Milrinone treatment group （ milrinone group, n = 25 ） were treated with 0.5 μg/（kg.min） milfinone. Dopamine and phentolamine treatment group （ dopamine group, n = 20 ） were administrated by 5 μg/（kg.min） dopamine and phentolamine. Both groups were administrated for 5 days. Clinical effect and changes of hemodynamies and heart function of 2 groups were observed and compared. Results Under 5 days treatment of milfinone, clinical symptom, physical sign, data of hemodynamies and heart function were obviously alleviated than before treatment （P, 〈 0.05 ）, the total effective rate of milinone group was 92.0%. While the effective rate of dopamine group was 92.0%, and the hemodynamies and heart function were not statistically advanced by dopamine therapy （ Pa 〉 0.05 ）. There were siginifieant differences of clinical effect and the changes of hemodynamies and heart function between milrinone and dopamine groups （ Pa 〈 0.05 ）. The heart rate and blood pressure of milrinone group were not remarkable changed after treatment eompaired with before treatment（Pa 〉0.05 ）,and severe arrhythmia did not happen. Conclusions Milrinone can obviously advance the heart function and depress pulmonary artery pressure in children with PAH induced by CHD,and not affect the heart rate and blood pressure of patients,which may profit from the positive myodynamia effect and the selective dila- tion to the pulmonary artery of milrinone. The clinical effect of milrinone is better than dopamine.

关 键 词：米力农 心脏病 先天性 肺动脉高压 心功能 血流动力学 

分 类 号：R725.4[医药卫生—儿科]