氨力农在充血性心力衰竭中的应用及对肾脏功能影响的研究

EMPLOYMENT OF AMIRINONE IN THE CONGESTIVE HEART FAILURE

采用国产氨力农（amirinone）对30例充血性心力衰竭病人进行临床治疗疗效观察。先以负荷量0．5－1.0mg／kg静脉内推注，继以维持量5－10μg·kg－1／min，静滴，共360分钟，每日1次，7天为一疗程。治疗前后复查超声心动图。结果表明，有73．4％的心力衰竭患者的心功能改善，治疗后左室收缩、舒张功能指标明显改善。治疗前测定血、尿β2微球蛋白均增高，且血β2微球蛋白与尿素氮成正相关，与肌酐清除率呈负相关。心衰改善后，血、尿β2微球蛋白降低（P＜0．05）。这提示国产氨力农可明显改善心衰患者的心功能及肾功能。血、尿β2微球蛋白测定可作为心衰时判断肾功能损害的指标。

Thirty cases of congestive heart failure were treated with intravenous injection of home-made amirinone, with aninitial bolus dose of 0. 5-1.0mg/kg, and then followed by maintenance dose of 5-10μg·kg-1·min-1, given within 360 minutes in total, once a day, for a course of 7 days. Echocardiogram before and after the treatment shows that the cardiac function of 73. 4% of the congestive heart failure cases has been improved; Comparison of serum and urine β2-MG be fore and after the treatment shows that patients are in heart failure, serum and urine β2-MG increased. These are positively correlated with BUN, but negatively correlated with endogenous creatinine clearance. When the heart failure has been improved, the serum and the urine β2-MG drop (P<0.05). All the above findings suggest that the home-made amirinone obviously improve the cardiac and kidney function in heart failure cases, and the serum and urine β2-MG determination may be regareded as indexes of judging kidney function for patients in heart failure.