米力农联合小剂量多巴胺和速尿治疗难治性心衰的临床效果分析

Analysis of milrinone in combination with small dose of dopamine and furosemide curative effect for treatment of intractable heart failure

目的观察米力农联合小剂量多巴胺和速尿治疗难治性心衰的临床疗效。方法将76例难治性心衰患者按入院顺序随机分为观察组与对照组各38例。观察组患者在常规治疗的基础上加用米力农、小剂量多巴胺和速尿治疗,对照组患者在常规治疗的基础上加用地高辛和速尿治疗,评价两组患者的临床治疗效果;测定患者治疗前后的左室射血分数(LVEF)、左心室舒张末内径(VEDD)以及血清N-末端B型利钠肽(NT-proBNP);同时统计患者的再入院率及猝死率。结果观察组患者治疗总有效率为84.21%,对照组为68.42%,组间差异有统计学意义(P<0.05)。观察组患者治疗后的平均LVEF指标值高于对照组(P<0.05),平均VEDD、NT-proBNP指标值均低于对照组(均P<0.05)。随访1年期间,观察组患者的再入院率、猝死率均低于对照组(均P<0.05)。结论米力农联合小剂量多巴胺和速尿治疗难治性心衰的临床疗效显著,能有效改善患者的心功能,延缓心衰进展,改善患者预后。

Objective To analyze clinical curative effect of milrinone in combination with small dose of dopamine and furosemide on treatment of intractable heart failure.Methods 76 patients with intractable heart failure were divided into the observation group（38cases）and the control group（38cases）.On the basis of routine therapy,the observation group patients were treated by milrinone,small dose dopamine and furosemide.The control group patients were treated by digoxin and furosemide.The clinical treatment effect were evaluated.The left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（VEDD）and serum N-terminal b-type natriuretic peptide（NT- proBNP）were determined.The patient＇s readmission rate and death rate was counted.Results The total effective rates of observation group and control group were 84.21% and 68.42%（P〈0.05）.After treatment,LVEF of the observation group was higher than that of the control group（P〈0.05）,VEDD and NT-proBNP of the observation group was lower than that of the control group（P〈0.05）.The readmission rate and death rate of observation group was lower than that of the control group（P〈0.05）.Conclusion Milrinone in combination with small dose of dopamine and furosemide in the treatment of intractable heart failure clinical curative effect can effectively improve cardiac function,delay the progress of heart failure,and improve the prognosis of patients.