米力农治疗急性心肌梗死后心力衰竭临床疗效观察

Observation on the clinical efficacy of milrinone in the treatment of heart failure patients with acute myocardial infarction

目的观察米力农治疗急性心肌梗死（AMI）后心力衰竭患者的临床疗效及安全性。方法选择住院治疗的AMI后出现心力衰竭患者103例，心功能Killip Ⅲ～Ⅳ级，随机分为对照组51例与治疗组52例。对照组予以常规控制心力衰竭治疗；治疗组在此基础上加用米力农，给予米力农负荷量50 μg/kg, 10 min缓慢静注，以后0.5 μg/（kg·min）静脉持续泵入, 5 d为1个疗程。治疗前后评估患者心功能指标变化。结果 治疗后2组患者脑钠肽（BNP）、左室射血分数（LVEF）、心排血量（CO）、心率（HR）、收缩压（SBP）、舒张压（DBP）等指标较治疗前均有明显改善（P〈0.05或P〈0.01），而治疗组治疗后BNP、LVEF、CO、HR水平明显优于对照组（P〈0.05或P〈0.01）, 治疗后2组SBP、DBP比较差异无统计学意义（P〉0.05）。治疗过程中未见明显不良反应。结论短期、小剂量持续应用米力农治疗AMI后心力衰竭安全有效。

Objective To explore the efficacy heart failure patients with acute myocardial infarction. and safety of milrinone in the treatment of Methods A total of 103 heart failure patients with acute myocardial infarction （Killip Ⅲ - Ⅳ ）were randomly divided into control group（ n = 51） and study group（ n = 52）. The control group received normal therapy, and the study group was intravenously injected with milrinone additionally. Milrinone with an initial 50μg/kg bolus in ten minutes was followed by a 0.5μg/（kg·min） with micro pump intravenously for 5 days as a course. The changes of heart functional parameters were detected before and after treatment. Results The brain natriuretic peptide（BNP）, left ventricular ejection fraction（LVEF）, cardiac output（CO）, heart rates（HR）, systolic blood pressure （SBP） and diastolic blood pressure（DBP） in both groups after treatment were significantly improved （P 〈 0.05 或 P 〈 0.01 ）. BNP, LVEF, CO and HR in the study group were obviously better than those in the control group after treatment （P〈0.05 ~ P〈0.01）, but SBP and DBP in the two groups showed no statistically significant differences （P〉0.05）. There were no serious side effects. Conclusion The short-time, low-dose continuous administration of milrinone is safe and effective in the treatment of heart failure patients with acute myocardial infarction.