米力农与硝普钠合用治疗难治性心力衰竭的临床价值

The Clinical Study of Combined Administration of Milinone and Sodium Nitroprusside on Refractory Heart Failure

目的:观察米力农与硝普钠合用治疗难治性心力衰竭患者的疗效。方法:选择90例难治性心力衰竭患者,随机分为A、B、C三组各30例,分别用米力农(对照组)、多巴酚丁胺(对照组)和米力农+硝普钠组(实验组)治疗,观察患者治疗前后心功能级别和心脏超声心功能指标(EF、CO、SV、CI和VA/VE)的变化情况。结果:A、B、C组总有效率分别为57%、47%和87%,差异有显著性(P<0.05)。结论:米力农适用治疗难治性心衰,尤其是不能耐受洋地黄药物治疗者,与硝普钠合用,临床疗效显著增加。

Objective:To explore the effect of combined administration of milinone and sodium nitroprusside on refractory heart failure. Methods:90 patients with refractory heart failure was randomized into group A, B, C and 30 cases each, treated by milinone, dobutamine and milinone combined with sodium nitroprusside. NYHA functional classification and echocardiography was conducted before and after the treatment, ejection fraction (EF), cardiac output (CO), stroke volume(SV), cardiac index(CI) and VA/VE were recorded. Results:The total efficiency in group A, B and C was 57%, 47% and 87% .The difference was significantly(P < 0.05). The echocardiography results improved in all the three groups (P < 0.05, especially in group C, P < 0.001). Conclusion:Milinone is a candidate for refractory heart failure, especially for the patients who are not suitable for digitalis and combined with sodium nitroprusside, the clinical effect improves significantly.