米力农联合曲美他嗪对充血性心力衰竭患者血流动力学、心率变异性的影响  

Effect of Milrinone combined with Trimetazidine on hemodynamics and heart rate variability in patients with congestive heart failure

作　　者：闫博宇[1] 刘婷[1] 杜倩 潘丽华[2] YAN Bo-yu;LIU Ting;DU Qian;PAN Li-hua(Department of Cardiovascular Medicine,People′s Hospital of Pingxiang City,Jiangxi Province,Pingxiang337000,China;Department of Cardiovascular Medicine,Affiliated Hospital of Nantong University,Jiangsu Province,Nantong226021,China)

机构地区：[1]江西省萍乡市人民医院心血管内科,江西萍乡337000 [2]南通大学附属医院心血管内科,江苏南通226021

出　　处：《中国当代医药》2020年第33期62-65,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204372)。

摘　　要：目的探讨米力农联合曲美他嗪对充血性心力衰竭(CHF)患者血流动力学、心率变异性的影响。方法选取2017年10月~2019年10月江西省萍乡市人民医院收治的100例CHF患者作为研究对象,根据随机数字表法将其分为对照组与观察组,每组各50例。对照组患者采用口服曲美他嗪治疗,观察组患者在对照组的基础上加用米力农治疗,两组均治疗1周。比较两组患者的临床疗效、心功能[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、N端脑钠肽原(NT-proBNP)]、血流动力学[心脏排血指数(CI)、每分心排血量(CO)]、心率变异性[24 h正常窦性R-R间期标准差(SDNN)、每5分钟R-R间期均值的标准差(SDANN)、正常响铃R-R间期差值>50 ms的百分比(PNN50)、低频带(LF)、高频带(HF)、LF/HF值]等相关指标水平及不良反应发生情况。结果观察组患者的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后观察组患者的LVESD、LVEDD、IVST、LVPWT、NT-proBNP水平低于对照组,CI、CO、SDNN、SDANN、PNN50、LF、HF、LF/HF水平高于对照组,差异有统计学意义(P<0.05)。两组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论CHF患者使用米力农和曲美他嗪联合治疗,可有效改善血流动力学、心率变异性相关指标,保护心功能,且安全性较高,为临床推广应用提供理论依据和新思路。Objective To investigate the effect of Milrinone combined with Trimetazidine on hemodynamics and heart rate variability in patients with congestive heart failure(CHF).Methods A total of 100 patients with CHF who were admitted to People′s Hospital of Pingxiang City in Jiangxi Province from October 2017 to October 2019 were selected as the research objects and divided into two groups according to random number table method,with 50 cases in each group.The control group was treated with oral Trimetazidine,and the observation group was treated with Milrinone on the basis of the control group,with 1 week of treatment in two groups.The curative effect,cardiac function(left ventricular end systolic diameter[LVESD],left ventricular end diastolic diameter[LVEDD],interventricular septal thickness[IVST],left ventricular posterior wall thickness[LVPWT],N-terminal pro-brain natriuretic peptide[NT-proBNP]),hemodynamics(cardiac index[CI],cardiac output[CO]),heart rate variability(standard deviation of normal to normal intervals[SDNN],standard deviation of per 5 min averages normal number of intervals[SDANN],24 h adjacent R-R interval difference>50 ms percentage[PNN50],low frequency[LF],high frequency[HF],LF/HF)and the adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The levels of LVESD,LVEDD,IVST,LVPWT and NT-proBNP in the observation group were lower than those in control group,the levels of CI,CO,SDNN,SDANN,PNN50,LF,HF,LF/HF in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Milrinone combined with Trimetazidine in the treatment of patients with CHF can improve hemodynamics and heart rate variability indexes,protect cardiac function and have highe

关 键 词：充血性心力衰竭 米力农 曲美他嗪 血流动力学 心率变异性 

分 类 号：R541.61[医药卫生—心血管疾病]