米力农治疗慢性心力衰竭伴缓慢性心律失常临床疗效及安全性观察

Clinical efficacy and safety of milrinone in chronic heart failure patients with bradyarrhythmias

目的观察米力农治疗慢性心力衰竭伴缓慢性心律失常患者的临床疗效及安全性。方法将63例慢性心力衰竭合并缓慢性心律失常的患者随机分为两组,对照组予以常规抗心衰治疗,治疗组在常规治疗基础上加用米力农。观察两组治疗前后临床心功能NYHA分级、B型利钠肽(BNP)水平、左室射血分数(EF)、左室舒张末期内径(LVEDD)、24小时动态心电图指标:平均心室率、室性心律失常、长RR间期。结果两组患者治疗后心功能分级、B型利钠肽(BNP)水平、左室射血分数(EF)均有显著改善,治疗前后差异具有统计学意义(P<0.05);治疗组较对照组患者BNP下降水平、LVEF升高幅度更显著,差异具有统计学意义(P<0.05);但两组左室舒张末期内径(LVEDD)治疗前后改善不明显,无统计学差异(P>0.05)。两组治疗前后平均心率、室性心律失常、长RR间期事件无明显增加,组间及组内差异无统计学意义(P>0.05)。结论在常规抗心衰治疗基础上短期使用米力农治疗慢性心力衰竭伴缓慢性心律失常,临床疗效显著且安全可靠。

Objective To observe the clinical efficacy and safety of milrinone in chronic heart failure （CHF） patients with bradyarrhythmias. Methods Sixty-three CHF patients with bradyarrhythmias were randomly divided into two groups： control group receiving conventional cardiotonic treatment and study group receiving milrinone in addition to conventional treatment. The treatment outcomes of the two groups were evaluated based on NYHA classification, B-type natriuretic peptide （BNP） level, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, and 24-hour Holter data （average ventricular rate, ventricular arrhythmias, and long RR interval）. Results After treatment, both groups showed significant improvements in NYHA classification, BNP level, and LVEF （P〈O.05）, and the treatment group had a significantly higher decrease in BNP level and a significantly higher increase in LVEF （P〈O.05）; however, the two groups showed no significant improvement in LVEDD （P〉0.05）. In addition, the two groups had no significant increases in average heart rate and the incidence of ventricular arrhythmia and long RR interval after treatment, and no significant differences were seen in these parameters between the two groups （P〉0.05）. Conclusion Short-term use of milrinone in addition to conventional cardiotonic treatment has significant clinical efficacy and good safety in CHF patients with bradyarrhythmias.