米力农治疗老年慢性肺心病心力衰竭的疗效观察  

Effects of milrinone on elderly patients with heart failure induced by chronic pulmonary heart disease

作　　者：马涵涛[1] 

机构地区：[1]河南科技大学第一附属医院,河南洛阳471003

出　　处：《中国新药与临床杂志》2014年第7期538-541,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的 观察米力农治疗老年慢性肺心病心力衰竭患者的临床疗效。方法 80例慢性肺心病患者随机分为对照组和治疗组,每组40例。两组患者入院后均给予持续低流量吸氧、控制感染,并进行利尿、纠正电解质紊乱、维持酸碱平衡、止咳祛痰、解痉平喘等综合治疗,对照组在上述治疗基础上静脉滴注多巴酚丁胺20～40 mg,qd,治疗组静脉滴注米力农50μg·kg-1,qd;两组均给药7 d。比较两组患者临床疗效、心率（HR）、动脉氧分压（PaO2）、动脉二氧化碳分压（PaCO2）及左室射血分数（LVEF）、每搏输出量（SV）、心脏指数（CI）、每分心排血量（CO）、二尖瓣血流舒张早期最大流速与舒张晚期最大流速的比值（E/A）等血流动力学变化。所有患者治疗前后,去蛋白法检测血浆中硫化氢（H2S）水平;免疫荧光法检测血浆中氨基末端B型脑钠肽（BNP）水平、D-二聚体水平。结果 治疗7 d后,治疗组总有效率为88%,略高于对照组（68%）,但两组相比无显著差异（P〉0.05）。与治疗前相比,两组患者HR均显著下降、PaO2明显增加、PaCO2明显下降,血流动力学均有显著改善（均P〈0.05）,治疗组改变更为显著（P〈0.05）。两组治疗后血浆H2S水平均明显增加,BNP、D-二聚体水平明显降低（均P〈0.01）,治疗组比对照组改变更显著（均P〈0.01）。结论 米力农治疗老年慢性肺心病心力衰竭疗效较好。AIM To explore the clinical effects of milrinone on elderly patients with heart failure induced by chronic pulmonary heart disease. METHODS A total of 80 patients with heart failure induced by chronic pulmonary heart disease were randomly divided into treatment group and control group, 40 for each group. Comprehensive therapies were given to both groups after hospitalization, including continuous oxygen inhalation in low flow, infection controlling, diuresis, electrolyte and acid base disturbance rectification, cough relieving to remove phlegm and spasm remising to relieve asthma. The treatment group was added with intravenous injection of milrinone 50 μg·kg-1, while the control group was intravenously injected with dobutamine 20 - 40 mg, qd for 7 d, respectively. Clinical effects, heart rate （HR）, arterial blood partial pressure of oxygen （PaOz） and partial pressure of carbon dioxide （PaCO2） , left ventricular ejection fraction （LVEF） , stroke volume （SV）, cardiac index （CI）, cardiac output （CO） per minute and the ratio of maximum flow velocity in diastolic early and late vacation of mitral valve flow （E/A） of both groups were observed and compared. After the treatment, serum sulfuretted hydrogen （H2S） level was detected with deproteinization method while serum amino- terminal B- type brain natriuretic peptide （BNP） and D- dimer levels were determined by immunoflurorescence method. RESULTS Total effective rate of the treatment group was 88% and the control group was 68%, but there was no significant difference between the groups （P 〉 0.05）. HR, PaCO2, BNP and D-dimer levels decreased while H2S and PaO2 levels increased obviously in both groups （P 〈 0.05）, and the treatment group was lower in HR, HzS and PaCO2 levels but higher in PaO2, BNP and D-dimer levels than the control group （P 〈 0.01 ）. Additionally, SV, CO, CI, LVEF and E/A increased evidently after the treatment （P 〈 0.05）, and the treatment group were higher than the control group （P �

关 键 词：米力农 肺心病 心力衰竭 充血性 硫化氢 利钠肽 脑 

分 类 号：R972.1[医药卫生—药品]