静脉滴注氨利酮对老年重度心力衰竭血液动力学的影响  

Effect of intravenous amrinone on hemodynamics in elderly patients with severe heart failure

作　　者：孙小丰[1] 陈丽清[1] 程梅芬[1] 林佩娣[1] 李勇[2] 范维琥[2] 

机构地区：[1]上海医科大学华山医院老年病科,上海200040 [2]上海医科大学华山医院心内科,上海200040

出　　处：《中国临床药学杂志》1999年第3期133-135,共3页Chinese Journal of Clinical Pharmacy

摘　　要：目的:观察氨利酮对老年重度充血性心力衰竭(CHF)的治疗作用.方法:采用开放、治疗前后自身对照方法对23例老年重度CHF患者iv gtt氨利酮治疗10d.观察对其心功能临床症状的影响,并用右心飘浮导管监测氨利酮首剂用药前后的血液动力学.结果:注射氨利酮后30min,心输出量(CO)、每搏量(SV)、心脏指数(CI)和每搏指数(SI)均显著提高,肺毛细血管锲嵌压(PCWP)显著降低(P<0.02);CO、SV、CI于注射后90min增加更为明显(P均<0.01),注射后30min体循环阻力指数(SVR)、肺循环阻力指数(PVR)也显著降低(P<0.05);心率、平均动脉压在用药期间无显著改变;治疗10d后心功能明显改善,从Ⅳ级转为Ⅱ级者7例,Ⅳ级转为Ⅲ级者6例,从Ⅱ级转为Ⅰ级者8例,无变化者2例(P<0.05).结论:氨利酮短期iv gtt对改善老年重度CHF患者的心功能方面具有较好的疗效.AIM:To assess the effect of intravenous amrinone in elderly patients with se-vere heart failure. METHODS: Twenty-three consecutive elderly patients with severe heart failure (NYHA Ⅲ-Ⅳ) were enrolled into an open, before-after study , receiving intravenous amrinone for 10 d,their hemodynamic changes were also monitored before and to 90 min after the first dose of amrinone infusion with right ventricular floating cardiac catheters. RE-SULTS:Cardiac output(CO) ,stroke volume(SV),cardiac index(CI)and stroke volume index (SI)increased significantly 30 min after the injection of amrinone(P<0. 05,P<0. 02) ,pul-monary arterial wedge pressure reduced significantly(P<0. 02),CO,SV and CI became more pronounced at 90 min after the injection(P<0. 01),systemic vascular resistance index(SVR) and pulmonary vascular resistance index (PVR) reduced significantly 30 min after the injec-tion(P<0.05); heart rate,mean arterial blood pressure did not change significantly ;cardiac function improved after 10 d treatment, 7 patient's cardiac function was improved from NY-HA Ⅳ to Ⅱgrade,6 patient's from Ⅳ to Ⅲ grade, 8 patient's from Ⅲ to Ⅱ grade and 2 patient's did not change (P<0.05). CONCLUSION: Short-term intravenous amrinone can improve cardiac function in elderly patients with severe heart failure.

关 键 词：氨利酮 血液动力学 充血性心力衰竭 老年人 

分 类 号：R541.605[医药卫生—心血管疾病]