米力农治疗老年人难治性心力衰竭58例临床分析

Analysis of Effect of Milrinone in Treatment of 58 Elderly Patients with Refractory Heart Failure

目的:观察米力农治疗老年人难治性心力衰竭的心功能变化和临床疗效。方法:在常规药物治疗基础上,治疗组40例加用米力农。其中19例先静注负荷量2.5mg/20min,再静滴维持量7.5mg/360min;11例静滴维持量加大为12.5mg/360min;10例为米力农10mg匀速静脉滴注360min。对照组18例则加用等量生理盐水。测定治疗前,治疗后20min、360min时心功能,治疗组另测定一疗程后心功能,并作临床疗效评估。结果:静注米力农负荷量后CO和CI显著提高,原心功能减退较轻者用7.5mg维持量能维持疗效,而心功能减退严重者7.5mg不足以维持疗效,必须加大维持量。持续匀速静脉滴注米力农CO和CI也有所改善,但无统计学意义。对照组心功能无变化。一疗程后,除1例死亡,其余39例临床心功能分级均有1～2级改善。结论:老年难治性心力衰竭加用米力农有助于改善心功能。

Objective： To observe the change of heart function and clinical effect of elderly patients with refractory heart failure treated by Milrinone. Methods： Based on the routine therapy of heart failure, Milrinone was used to 40 patients in therapeutic group.19 of them were injected Milrinone 2.5 mg in 20 min, then 7.5 mg in 360 min. The maintaining dose of other 11 patients was increased to 12.5 mg.10 mg Milrinone was infused with uniform speed in 360 min in 10 patients. 18 patients in control group were treated with normal saline. Heart function and clinical effect were estimated before and after one course of treatment. Results： After loading dose infusion, CO and CI were significantly improved. In patients with mild heart failure, maintaining dose of 7.5mg can keep the effect, but in patients with severe heart failure,the maintaining dose should be increased to 12.5 mg. CO and CI were improved unstatisticaUy by continuous infusion with even speed. No change was found in control group. After one course of treatment, 1 patient died. The heart function of the remaining was all improved by 1-2 degrees. Conclusion： The usage of Milrinone to elderly patients with refractory heart failure was effective and safe.