米力农对持续性肺动脉高压患儿心室功能的影响  

Effects of milrinone on the ventricular function in children with persistent pulmonary hypertension of newborn

作　　者：郑烜 赵杨[2] 文基功 

机构地区：[1]开封市儿童医院设备科,河南开封475000 [2]河南大学淮河医院医保科,河南开封475000

出　　处：《中国急救医学》2017年第4期334-339,共6页Chinese Journal of Critical Care Medicine

摘　　要：目的评估米力农治疗对新生儿持续性肺动脉高压（PPHN）患儿心室功能的影响。方法选取75例在我院新生儿重症监护室（NICU）治疗的PPHN患儿，患儿均经过4h的20ppm一氧化氮（NO）吸入治疗但未改善，随后给予米力农注射液维持量静滴，剂量0．30-0．75μg／（kg·min）。在基线期及治疗24～72h后对所有患儿进行超声心动图检查，采用心电监护仪监测患儿血压、心率、呼吸与血氧饱和度（SpO2）。结果米力农治疗后，患儿氧合指数（OF）显著改善（P=0．009）；右心室基底段纵向应变、基底段纵向收缩应变率及切面面积变化分数显著提高（分别P=0．022、P=0．003与P=0．008），右心室输出量显著提高（P=0．005）；左心室二尖瓣环收缩期运动峰值速度（sm）与二尖瓣环舒张晚期运动峰值速度（am）显著提高（分别P〈0．001和P=0．035）；同时，左心室心肌性能指数（Tei）与左心室输出量显著改善（分别P=0．036与P=0．042）。结论米力农作为NO吸入治疗的辅助药物，可以显著改善PPHN患儿的氧合与心室功能。Objective To evaluate the effect of milrinone on ventricular function in children with persistent pulmonary hypertension of newborn （PPHN）. Methods 75 newborns with PPHN who were treated in neonatal intensive care unit （ICU） in our hospital were treated with 20 ppm nitric oxide （NO） inhalation for 4 h but not improved, and then infused with milrinone infusion, with the dose of 0.30 - 0.75 μg/（kg· min）. Echoeardiography was performed at baseline and at 24 - 72 h after treatment. Blood pressure, heart rate, respiration and SpO2 were monitored with ECG monitor. Results The oxygenation index （OI） of children with milrinone was significantly improved （P = 0.009）. The longitudinal strain, basal segment longitudinal contraction strain rate and the change area of the right ventricle were significantly increased （ P = 0.022, P = 0.003 and P = 0.008, respectively ）. The peak systolic velocity （sin） of left ventricular mitral annulus was significantly higher than that of mitral annulus （P 〈 0.001 and P = 0.035, respectively）. At the same time, left ventrieular mass index （Tel） and left ventricular output were significantly improved （P = 0.036 and P = 0.042, respectively）. Conclusion Milrinone is an adjunctive drug for the inhalation of nitric oxide, which can significantly improve oxygenation and ventricular function in neonates with PPHN.

关 键 词：新生儿持续性肺动脉高压(PPHN) 心室功能 一氧化氮(NO) 米力农 

分 类 号：R543.2[医药卫生—心血管疾病]