米力农联合曲美他嗪治疗充血性心力衰竭的血流动力学变化

Hemodynamic change caused from milrinone combined trimetazidine treatment for congestive heart failure

目的:观察米力农联合曲美他嗪治疗充血性心力衰竭(CHF)所致的血流动力学变化。方法:CHF患者125例,随机分为三组,常规治疗组(40例),米力农组(42例,常规治疗基础上加用米力农),米力农加曲美他嗪组(43例,常规治疗基础上加用米力农联合口服曲美他嗪),10d为1个疗程,观察各组治疗前后疗效及各指标变化情况。结果:米力农联合曲美他嗪治疗CHF临床总有效率(88.3%)显著高于常规治疗组(65.0%)。与常规治疗组和米力农组治疗后比较,米力农联合曲美他嗪组每搏量[SV,(49±8.1)ml、(54.4±8.2)ml比(61.5±8.2)ml]、心排血量[CO,(4.3±0.6)L/min、(4.7±0.5)L/min比(5.7±0.7)L/min]、心脏指数[CI,(3.2±0.8)L·min-1·m-2、(3.6±0.5)L·min-1·m-2比(4.2±0.6)L·min-1·m-2]、左室射血分数[LVEF,(42.2±8.2)%、(47.6±8.2)%比(52.8±8.1)%]和二尖瓣血流舒张早期与舒张晚期最大流速的比值[E/A,(1.0±0.3)、(1.2±0.2)比(1.4±0.3)]均显著升高(P均<0.05)。结论:米力农联合曲美他嗪治疗充血性心力衰竭可明显改善心衰患者的心功能。

Objective： To observe hemodynamic change caused from milrinone combined trimetazidine treatment for congestive heart failure （CHF）. Methods： A total of 125 CHF patients were randomly divided into routine treat-ment group （n = 40）, milrinone group （n = 42, received milrinone based on routine treatment） and milrinone ＋ tri-metazidine group （n = 43, received milrinone combined trimetazidine based on routine treatment）, and 10d was re-gard as a course of treatment. Curative effect and changes of indexes were observed in all groups before and after treatment. Results： Clinical total effective rate of milrinone ＋ trimetazidine group （88. 3%） was significantly higher than that of routine treatment group （65.0%）, P〈0.05 all. Compared with routine treatment group and milrinone group after treatment, there were significant increase in stroke volume [SV, （49 ± 8.1） ml, （54.4 ± 8.2） ml vs. （61.5 ± 8.2） ml], cardiac output [CO, （4.3 ± 0.6） L/rain, （4.7 ± 0.5） L/min vs. （5.7 ± 0.7） L/mini, cardiac in-dexCCI, （3.2±0.8） L·min^-1·m^-2, （3.6±0.5） L·min^-1·m^-2 vs. （4.2±0.6）L·min^-1·m^-2], leftventric-ular ejection fraction [LVEF, （42.2 ± 8.2）%, （47.6 ± 8.2）% vs. （52.8 ± 8.1）%] and transmitral early diastolic peak flow velocity/late diastolic peak flow velocity [E/A, （1. 0 ± 0.3）, （1.2 ± 0.2） vs. （1.4 ± 0.3）] in milrinone ＋ trimetazidine group, P〈0.05 all. Conclusion.. Milrinone combined trimetazidine therapy can significantly improve heart function in patients with congestive heart failure.