米力农对肺心病肺循环作用的选择性研究

The Selective Effect of MiLinone on Pulmonary Circulation of Cor Pulmonale

目的 研究米力农对肺心病肺循环作用的选择性。方法 肺心病心衰者 5 0例 ,在常规治疗的基础上分为两组 ,治疗组2 6例加用米力农 ;对照组 2 4例加用多巴酚丁胺 :qd× 10～ 14天为一个疗程。结果 两组治疗肺心病心衰临床有效率分别为 :治疗组 88.5 %和对照组 83 .3 %。心功能指标 CO、CI、L VEF两组均有明显上升。血液动力学指标 m PAP和 PVR治疗组明显降低 ( P<0 .0 1) ,分别下降为 2 7.9%、2 4 .4 % ,而 SBP、HR无明显变化 ;对照组亦有所下降 ,下降率分别为 10 .3 % ,11.6% ,但差异无显著性 ( P>0 .0 5 ) ,同时 SBP下降、HR增加。两者对肺、体循环的选择性指标△m PAP/△ SBP分别为 0 .67± 0 .0 3 ,0 .3 4± 0 .0 5。结论 米力农具有降低肺动脉高压、肺血管阻力的作用 ,更具有对肺循环的选择性 ,而且不影响体循环 ,不增加心率 ,其疗效显著 。

Objective To study the selectivity of mirillon in pulmonary circulation of cor pulmonale.Methods On the basis of regular therapy,50 cor pulmonale patients whose cardic function were insufficient were divided into two groups:26 cases were treated with mirillon(therapy group) and 24 were treated with dopa for 10 to 14 days(control).Results Clinical effective rate in the therapy group was 88.5% while in control group 83.3%.Cardic functional index of CO?CI?LVEF in both groups were elevated obviously.Blood dynamic index of mPAP and PVP were reduced:for the therapy group:27.9% and 24.4%(P<0.01).SBP and HR remained unchanged in both groups.In control group mPAP and PVP were reduced:10.3% and 11.6%,but the difference was not significant.(P>0.05).In the meantime SBP dropped and HR elevated.Selective index to pulmonary and systemic circulation △mPAP/△SBP were 0.67±0.03 and 0.34±0.05.Conclusion MiLinone could reduce pulmonary artery hypertention and pulmonary vascular resistance.It had high selectivity to pulmonary circulation without influence to systemic circulation and heart rate.Mirillon is effective and safe in the treatment of cor pulmonale.