米力农注射液联合曲美他嗪治疗高血压性心脏病伴CHF的疗效及其对心功能、运动耐量的影响  

Therapeutic effect of milrinone injection combined trimetazidine on hypertensive heart disease complicated CHF and its influence on cardiac function and exercise tolerance

作　　者：曹磊[1] 薛霞 曹星 CAO Lei;XUE Xia;CAO Xing(Department of Cardiology and Kidney Medicine,Xi'an Electric Power Central Hospital,Xi'an,Shaanxi,710032,China)

机构地区：[1]西安电力中心医院心内科,陕西西安710032 [2]中航工业西安医院

出　　处：《心血管康复医学杂志》2020年第1期94-98,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究米力农注射液联合曲美他嗪治疗高血压性心脏病伴慢性心力衰竭(HHD+CHF)的疗效及其对心功能、血压及运动耐量的影响。方法:2017年1月~2018年2月我院收治的100例HHD+CHF患者被随机均分为米力农组(在常规治疗基础上接受米力农注射液)和联合治疗组(在米力农组基础上加用曲美他嗪),两组均治疗2个月。观察比较两组治疗前后心功能指标:左室舒张末期内径(LVEDd)、LVEF、心脏指数(CI)及血清钠尿肽(BNP)水平,血压、6min步行距离(6MWD)、治疗总有效率、不良反应发生率及6个月、12个月再住院率和死亡率。结果:联合治疗组总有效率显著高于米力农组(94.00%比72.00%,P=0.003)。与米力农组比较,联合治疗组治疗后LVEDd [(55.51±5.24)mm比(50.62±5.64)mm]、血清BNP水平[(430.32±290.21)ng/L比(270.63±232.41)ng/L]降低更显著,LVEF [(39.57±5.21)%比(46.41±6.13)%]、CI[(3.46±1.51)L·min-1·m-2比(4.32±1.17)L·min-1·m-2]、6MWD [(240.95±38.16)m比(340.25±40.36)m]升高更显著(P均<0.01)。两组不良反应发生率无显著差异(P=0.538)。随访期间,联合治疗组6个月再住院率(6.00%比20.00%)、12个月再住院率(18.00%比40.00%)均显著低于米力农组(P均<0.05)。结论:米力农注射液联合曲美他嗪治疗HHD+CHF的疗效显著,可显著改善患者心功能,运动耐量并改善预后。Objective:To explore therapeutic effect of milrinone injection combined trimetazidine on hypertensive heart disease complicated chronic heart failure(HHD+CHF)and its influence on cardiac function,blood pressure and exercise tolerance.Methods:A total of 100 HHD+CHF patients in our hospital from Jan 2017 to Feb 2018 were randomly and equally divided into milrinone group(received milrinone injection based on routine treatment)and combined treatment group(received trimetazidine based on milrinone group),both groups were treated for two months.Cardiac function indexes:left ventricular end diastolic diameter(LVEDd),LVEF,cardiac index(CI)and serum level of brain natriuretic peptide(BNP),blood pressure and 6-min walking distance(6 MWD)before and after treatment,total effective rate,incidence rate of adverse reactions,6-and 12-month rehospitalization rates and mortality rates were observed and compared between two groups.Results:Total effective rate of combined treatment group was significantly higher than that of milrinone group(94.00% vs.72.00%,P=0.003).Compared with milrinone group after treatment,there were significant reductions in LVEDd [(55.51±5.24)mm vs.(50.62±5.64)mm]and serum BNP level[(430.32±290.21)ng/L vs.(270.63±232.41)ng/L],and significant rise in LVEF [(39.57±5.21)%vs.(46.41±6.13)%],CI [(3.46±1.51)L·min-1·m-2 vs.(4.32±1.17)L·min-1·m-2]and 6 MWD [(240.95±38.16)m vs.(340.25±40.36)m]in combined treatment group(P<0.01 all).There was no significant difference in incidence rate of adverse reactions between two groups(P=0.538).During follow-up,6-month rehospitalization rate(6.00% vs.20.00%)and 12-month rehospitalization rate(18.00% vs.40.00%)of combined treatment group were significantly lower than those of milrinone group(P<0.05 both).Conclusion:Milrinone injection combined trimetazidine possesses significant therapeutic effect on HHD+CHF.It can significantly improve cardiac function,increase exercise tolerance and prognosis.

关 键 词：高血压 心力衰竭 米力农 曲美他嗪 性心脏病 慢性心力衰竭 心功能 血压 运动耐受量 

分 类 号：R544.1[医药卫生—心血管疾病]