米力农联合无创机械通气对重症心力衰竭患者心功能及COR、BNP水平和预后的影响

Effects of Milrinone Combined with Non-Invasive Mechanical Ventilation on Cardiac Function, COR, BNP Levels and Prognosis in Patients with Severe Heart Failure

目的探讨米力农联合无创机械通气对重症心力衰竭(SHF)患者心功能及血浆皮质醇(COR)、脑钠肽(BNP)水平和预后的影响.方法选取我院2019年6月—2020年11月收治的120例SHF患者为研究对象,将患者随机分为两组,每组60例.两组均接受常规治疗,对照组在此基础上采用无创机械通气治疗,观察组则在对照组基础上联合米力农治疗.对比两组的治疗效果.结果观察组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,观察组左心室射血分数、心脏指数均高于对照组,组间差异有统计学意义(P<0.05).两组患者治疗后左心室舒张末期内径、左心室收缩末期内径比较,组间差异无统计学意义(P>0.05).观察组患者治疗后血浆COR水平高于对照组,血浆BNP、血清超敏C反应蛋白水平均低于对照组,组间差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).随访6个月,观察组再住院率明显低于对照组,差异有统计学意义(P<0.05).结论米力农联合无创机械通气治疗SHF患者的疗效显著,可以有效改善其心功能,减轻机体炎症反应,降低不良反应发生率及再住院率,值得临床推广.

Objective To investigate the effects of milrinone combined with non-invasive mechanical ventilation on cardiac function,plasma cortisol(COR),brain natriuretic peptide(BNP)levels and prognosis in patients with severe heart failure(SHF).Methods A total of 120 patients with SHF admitted to our hospital from June 2019 to November 2020 were selected as the research objects,and the patients were randomly divided into two groups with 60 cases in each group.Both groups received conventional treatment,the control group was treated with non-invasive mechanical ventilation on this basis,and the observation group was treated with milrinone on the basis of the control group.The treatment effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the left ventricular ejection fraction and cardiac index in the observation group were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in left ventricular enddiastolic dimension and left ventricular endsystolic dimension between the two groups after treatment(P>0.05).After treatment,the plasma COR level of the observation group was higher than that of the control group,the plasma BNP and serum hypersensitive C-reactive protein levels were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).During the 6-month followup,the readmission rate of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Milrinone combined with non-invasive mechanical ventilation has significant curative effect in the treatment of SHF patients,can effectively improve their cardiac function,reduce the body's inflammatory response,and reduce the incidence of adverse reactions and rehospitalization rates,which is worthy of clinical promotion.