国产米力农对慢性充血性心力衰竭患者的血流动力学效应及临床疗效

Hemodynamics and clinical response with intravenous domestic milrinone in patients with chronic severe congestive heart failure

为验证国产米力农治疗慢性充血性心力衰竭（ＣＨＦ）的效果，对４０例ＣＨＦ患者分①血流动力学观察组１０例，采用安慰剂对照、随机双盲、自身交叉试验，②临床观察组３０例，又等分为米力农治疗组和安慰剂对照组进行观察。结果：血流动力学观察组用米力农后平均肺毛细血管楔压下降２７．４％，平均肺动脉压下降２４．５％，体循环血管阻力下降２０．６％，心脏指数增加１２．８％，均Ｐ＜０．０５；临床观察组中的米力农组心功能改善１１例（１１／１５，７３．３％），而安慰剂对照组仅４例（４／１５，２６．７％），两相比较，Ｐ＜０．０５。表明：应用国产米力农，可显著改善ＣＨＦ患者的血流动力学状况和心功能。

Abstract All patients with class Ⅲ or class Ⅳ congestive heart failure were divided into two parts:Part Ⅰ.In a randomized,double blind,placebo-controlled,cross-over trial,the hemodynamics of 10 patients received a loading dose(50 micrograms/kg) and a 4h continuous infusion(0.5 micrograms/kg/min) of milrinore were investigated.Milrinone therapy resulted in a 27.4% decrease in pulmonary capillary wedge pressure(P<0.05),a 20.6% decrease in systemic vascular resistance(P<0.05) and a 12.8% increase in cardiac index(P<0.05).There were no clinica1ly significant changes in heart rate and arterial blood pressure,Part Ⅱ.30 patients were randomly assigned to treatment with milrinone(n=15) or placebo(n=15).Milrinone was given intravenously as a 50 micrograms/kg bolus followed by a 4h infusion(0.5 micrograms/kg/min)for 7 days.Milrinone favourablly influenced symptoms and heart function in 11/15(73.3%) of patients,Side effects were minimal.In placebo group,only 4/15(26.7%) of patients had such response(P<0.05).