米力农治疗小儿充血性心力衰竭疗效观察

Study on the clinical curative effect and security of using maintenance dose Milrinone on treating congestive heart failure of children

目的探讨米力农治疗小儿充血性心力衰竭(CHF)的疗效及安全性。方法研究对象为广西壮族自治区人民医院2004—2006收治的40例CHF患儿,随机分为A、B二组。A组20例为米力农组,米力农剂量为0.5μg/(kg.min),B组20例为多巴胺组,剂量均为5μg/(kg.min),各组持续给药5d,观察维持量的米力农临床疗效和心功能指标的变化,并与多巴胺组进行比较。结果米力农组用药3～5d后,临床症状、体征及心功能指标均有显著改善(P<0.05),总有效率95.0%;多巴胺组临床有效率仅为75.0%,治疗前后心功能指标改善不明显(P>0.05);A、B两组治疗后临床疗效和心功能指标比较有统计学意义(P<0.05)。而血、尿常规,肝、肾功能及血小板计数均无异常,心电图无改变,心率、血压无显著变化(P>0.05),无严重心律失常的发生。结论维持量的米力农治疗小儿CHF是安全、有效的,其疗效优于多巴胺。

Objective To study the clinical curative effect and security of using milrinone on treating children congestive heart failure （CHF）. Methods Forty children with CHF were divided into group A and group B randomly. Group A （20 patients ） were administrated by venous injection of milrinone with a dose of 0. 5 ug / （ kg· min） for 5 days ; group B （ 20 patients） were administrated by venous injection of dopamine with a dose of 5ug/ （kg·min） for 5 days. Observe the clinical effect and the heart function of group using maintenance dose Milrinone, and compare with the group using dopamine. Results After using milrinone for 3 - 5 days ,the clinical manifestation, physical sign and the heart function of patients in group A had remarkable advancement（ P 〈0. 05 ）. The total effect rate of milrinone reached 95.0% ,and the total effect rate in group B only reached 75.0% ; the advancement of heart function were not obvious （ P 〉 0. 05 ）. The difference of clinical effect and the heart function after the therapy between group A and B was of statistical significance （ P 〈 0. 05 ）. In group A, the routine blood and urine test,the function of liver and kidney, and the plntelet count were normal, ECG was unchanged, the heart rate and blood pressure had unremarkable change （ P 〉 0.05 ） , and severe arrhythmia did not happen. Conclusion Using maintenance dose milrinone on treating children congestive heart failure is effective and secure,which is more effective than dopamine