环磷腺苷葡胺联合米力农与洋地黄治疗慢性肺心病心力衰竭的疗效  

Comparison of curative effect and safety of adenosine cyclophosphate combined with milrinone vs digitalis in the treatment of patients with chronic pulmonary heart disease

作　　者：蔡雪莹[1] 曾惠清[1] 陈波[1] 

机构地区：[1]厦门大学附属中山医院呼吸内科(福建医科大学教学医院),福建厦门361004

出　　处：《临床肺科杂志》2013年第4期608-609,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的比较环磷腺苷葡胺联合米力农与洋地黄类强心剂治疗慢性肺心病心力衰竭的疗效与安全性。方法采用随机、平行对照的研究方法,对108例慢性肺心病心力衰竭随机分成两组:治疗组(54例)在常规治疗的基础上加用环磷腺苷葡胺和米力农;观察组(54例)在常规治疗的基础上加用洋地黄(西地兰针),12天一疗程。结果治疗组总有效率94.4%,明显优于观察组66.6%(P<0.01),治疗组心功能指标右室内径、右心室流出道/左心房内径及心胸比例的改善明显优于观察组(P<0.01),肺功能、PaO2、PaCO2及脑钠肽改善明显优于观察组(P<0.01),而心率、血压无明显差异(P>0.05);治疗组不良反应主要有心悸、出汗、头痛,减慢静滴速度症状消失,观察组主要不良反应心律失常,常需停药。结论环磷腺苷葡胺联合米力农治疗慢性肺心病心力衰竭有更好的疗效,更少的副作用,值得临床上进一步推广应用。Objective To compare the clinical effect and safety of cyclophosphate combined with milrinone vs digitalis in the treatment of patients with chronic pulmonary heart disease. Methods 108 patients were all given conventional treatment and then were randomly and evenly divided into two groups. The treatment group was treated with cyclophosphate combined with milrinone additionally, and the control group was treated with digitalis additionally. 12 days were a treatment course. Results The total effective rates were 94. 4% and 66.6% respectively in the treatment group and in the control group （ P 〈 0.01 ）. The improvement of heart function, lung function, blood gas indexes and BNP was more pronound in the trcatatment group than in the control group （P 〈0.01 ）. There was no sig- nificant difference of heart rate and blood pressure hetween the two groups （P 〉0. 05 ）. The adverse effects in the treatment group includ- ed palpitation, diaphoresis and headache which disappeared by reducing the infusion rate, while the major adverse effects in the control group was arrhythmia which often ended up with withdraw of the drug. Conclusion The combination of cyclophosphate and milrinone has a better curative effect with less adverse effect in the treatment of patients with chronic pulmonary heart disease, and it＇s worth to be ap- plied widely in clinical practice.

关 键 词：环磷腺苷葡胺 米力农 洋地黄 肺心病 心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]