奥普利农与米力农在新生儿先心病双心室纠治术后效果的比较  

Comparison of the effect of orplinone and Milrinone after biventricular repair of neonatal congenital heart disease

作　　者：黄红娟 李炘 沈维嘉 袁洪樑 沈啸威 冉旭东[1] 廖健毅[1] 徐贵英 徐婉玉 Huang Hongjuan;Li Xin;Shen Weijia;Yuan Hongliang;Shen Xiaowei;Ran Xudong;Liao Jianyi;Xu Guiying;Xu Wanyu(Department of Cardiothoracic Surgery,Children's Hospital Affiliated to Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属儿童医院心胸外科,苏州215000

出　　处：《中华胸心血管外科杂志》2023年第11期647-652,共6页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：苏州市卫生健康委员会科技项目(LCZX202007)。

摘　　要：目的回顾性比较PDE3抑制剂奥普利农和米力农的临床疗效。方法收集2018至2022年苏州大学附属儿童医院心胸外科体外循环下新生儿先心病双心室纠治术后患儿41例,其中奥普利农组25例,米力农组16例,总结并研究患儿肾功能、心脏功能改善及心律失常发生率。结果两组术后1天射血分数(EF)均下降(P<0.01);术后4天奥普利农组EF较术后1天显著升高(P<0.01),米力农组较术后1天升高(P<0.05),且同期奥普利农组EF较米力农组显著升高(P<0.01);米力农组术后7天EF较术后4天继续升高(P<0.01),但两组间比较差异无统计学意义;远期随访发现奥普利农组术后7天EF较远期差异无统计学意义(P>0.05),而米力农组远期EF高于术后7天(P<0.05)。奥普力农组术后4、7天肌酐水平持续下降(P<0.01,P<0.05);米力农组术后4天较术后1天肌酐水平下降显著(P<0.01),术后7天较术后4天下降不明显;术后7天奥普利农组肌酐水平较米力农组更低(P<0.05)。患儿心律失常发生率奥普利农组比值稍降;而米力农组无变化。结论奥普利农改善新生儿先心病双心室纠治术后心功能效果优于米力农,且恢复至正常心功能时间更短;在肾功能保护方面,奥普利农强于米力农,且奥普利农对于肾脏保护作用持续时间较长;心律失常发生率方面两种药物差异无统计学意义。Objective To retrospectively compare the clinical efficacy of two PDE3 inhibitors,oplinone and Milrinone,in order to evaluate which drug has better effects on the improvement of cardiac function,protection of renal function and adverse effects of arrhythmia.Methods A total of 41 neonates with congenital heart disease after biventricular treatment under cardiopulmonary bypass in the Department of Cardiothoracic Surgery at Soochow University Children's Hospital during 2018-2022 were collected.The experimental group was divided into two groups:Oprilinone(25 cases)and Milinone(16 cases).A retrospective study was conducted on the incidence of renal function,cardiac function improvement and arrhythmia in the children.Results On the first day after operation,EF in both groups decreased significantly compared with that before operation(P<0.01);On day 4 after surgery,EF in the oprilinone group was significantly higher than that on day 1 after surgery(P<0.01),Milrinone group was slightly higher than that on day 1 after surgery(P<0.05),and EF in oprilinone group was significantly higher than that in Milinone group during the same period(P<0.01);EF in Milinone group continued to increase on day 7 compared with day 4(P<0.01),but there was no significant difference between the two groups.Long-term follow-up showed that there was no significant difference in EF value in the oprilinone intervention group on day 7 after surgery(P<0.05),and the long-term EF in Milinone group was higher than that at 7 days after surgery(P<0.05).The creatinine level in the oprinone intervention group continued to decrease on the 4th and 7th day after surgery(P<0.01;P<0.05);The creatinine level of Milinone group on day 4 after surgery was significantly lower than that on day 1 after surgery(P<0.01),the decrease was not significant on the 7th day after surgery compared with the 4th day after surgery;The creatinine level in the oprilinone group was lower than that in the Milrinone group on day 7 after surgery(P<0.05).The rate of arrhythmia in children

关 键 词：先天性心脏病 奥普利农 米力农 新生儿 心功能不全 急性肾功损伤 

分 类 号：R726.5[医药卫生—儿科]