米力农对扩张型心肌病患者肿瘤坏死因子α和左室射血分数及肺动脉收缩压的影响  

Effects of Milrinone on Tumor Necrosis Factor Alpha,Left Ventricular Ejection Fraction and Pulmonary Artery Systolic Pressure in Dilated Cardiomyopathy Patients

作　　者：李利强[1] 张瑞红[1] 

机构地区：[1]江苏省徐州市第一人民医院心内科,221002

出　　处：《实用心脑肺血管病杂志》2013年第9期31-33,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的研究米力农对扩张型心肌病(DCM)患者血清肿瘤坏死因子α(TNF-α)、心脏左室射血分数(LVEF)及肺动脉收缩压(PASP)的影响,探讨米力农治疗DCM的可行性及病理生理学机制。方法 80例DCM患者随机分为3组。对照组(30例)使用常规药物治疗;低剂量米力农组(28例)在常规药物治疗的基础上静脉使用米力农(2周内总药量≤100mg);高剂量米力农组(22例)在常规药物治疗的基础上静脉使用米力农(2周内总药量>100mg)。于研究开始及2周后用酶联免疫吸附法(ELISA)测定患者血清TNF-α水平、通过超声心动图计算患者的LVEF及PASP,并进行统计学分析。结果治疗后高剂量米力农组TNF-α水平高于低剂量米力农组和对照组,低剂量米力农组TNF-α水平高于对照组,差异有统计学意义(P<0.05);高、低剂量米力农组LVEF高于对照组,PASP低于对照组,差异有统计学意义(P<0.05)。结论米力农会增加患者TNF-α水平,同时提高患者LVEF、降低PASP。低剂量使用米力农可通过血流动力学的改善在一定程度上代偿了TNF-α水平的增高,对预后影响不大。而大剂量使用米力农后TNF-α水平会显著增加,且不能完全通过血流动力学代偿,对预后不利。Objective To study the effects of Milrinone on tumor necrosis factor - α （ TNF -α）, left ventricular e- jection fraction （LVEF） and pulmonary artery systolic pressure （PASP） in dilated cardiomyopathy （DCM） patients. To discuss the feasibility of milrinone treatment in DCM and its pathophysiology mechanism. Methods 80 cases of DCM patients were ran- domly divided into three groups. The control group （30 cases） was diven conventional drug therapy; Low -dose milrinone group （28 cases） was added the intravenous milrinone therapy （the amount was less than 100mg within 2 weeks） ; High -dose milri- none group （22 cases） was given the same way but the amount of milrinone was over 100mg within 2 weeks. At the beginning and two weeks later of the study, the serum TNF - αconcentration was determinated by senzyme - linked immunosorbent assay （ELISA）, the LVEF and PASP were calculated via echocardiography, finally analyzed statistically. Results After treatment, the TNF - α concentrations of high dose milrinone group was higher than that of low dose milrinone group and the control group, the TNF -α concentrations of low dose milrinone group was higher than that of control group （ P 〈 0. 05 ） ; The LVEF of high and low dose milrinone group was higher than that of control group, PASP was lower than that of control group, the difference was sta- tistically significant （P 〈 0.05 ）. Conclusion Milrinone therapy may increase the concentration of TNF - α, meanwhile can improve LVEF of patient, lower PASP. By improving hemodynamic, which can compensate the increasing levels of TNF - α, low doses treatment has little effect on the prognosis. While high - dose milrinone treatment is unfavorable for prognosis. Because TNF - α increases significantly, and can not be fully hemodynamic decompensation.

关 键 词：心肌病 扩张型 肿瘤坏死因子Α 左室射血分数 肺动脉收缩压 米力农 

分 类 号：R542.2[医药卫生—心血管疾病]