米力农治疗全身炎症反应综合征合并急性心力衰竭的临床疗效及安全性评价

Clinical efficacy and safety of milrinone in the treatment of patients with systemic inflammatory response syndrome and heart failure

目的评价米力农治疗全身炎症反应综合征合并急性心力衰竭的临床疗效及安全性。方法将76例全身炎症反应综合征合并急性心力衰竭患者随机分为对照组35例和试验组41例。对照组予以去乙酰毛花苷丙0.2~0.4 mg＋5%葡萄糖20 m L静脉缓慢注射,每日1~2次,连续5 d;试验组予以米力农5~10 mg＋5%葡萄糖注射液250 m L,用静脉输液泵以0.4~0.6μg·kg^-1·min^-1泵入,每日1~2次,连续5 d。比较2组患者的临床疗效和治疗前后血清脑钠肽水平、心率、收缩压、舒张压、每分输出量、左心室射血分数等指标以及不良反应发生率。结果治疗后,试验组的总有效率为92.68%,对照组的总有效率为94.29%,差异无统计学意义（P〉0.05）。治疗后,2组患者的血清脑钠肽水平、心率、收缩压、舒张压等指标较治疗前均显著降低（P〈0.05）,每分输出量、左心室射血分数水平较治疗前均显著升高（P〈0.05）,但上述指标的2组组间比较差异无统计学意义（P〉0.05）。2组患者不良反应发生率比较差异无统计学意义（P〉0.05）。结论米力农治疗全身炎症反应综合征合并急性心力衰竭的临床疗效确切,可显著改善患者心力衰竭症状,与去乙酰毛花苷丙无明显差异。

Objective To evaluated the clinical effects and safety of mil- rinone in the treatment of patients with systemic inflammatory response syndrome （SIRS） and heart failure. Methods Seventy - six cases with SIRS and heart failure were divided into control group （ n = 35 ） and experiment group （ n = 41 ）. Patients in the control group were given cedilanid 0. 2 -0. 4 mg ＋ 5% glucose 20 mL intravenous injection 1 - 2 times a day for 5 days. Patients in the experiment group were given milri- none 5 - 10 mg ＋ 5% glucose 250 mL intravenous infusion with 0. 4 - 0.6 μg·kg^-1·min^-1 1 - 2 times a day for 5 days. The clinical efficacy, serum brain natriuretie peptide （BNP）, heart rate （HR）, systolic blood pressure （ SBP）, diastolic blood pressure （ DBP）, cardiac output（ CO ）, left ventricular ejection fraction （LVEF） as well as the incidence of adverse drug reactions were compared between the two groups. Results After treatment, the clinical efficacy were 92. 68% and 94. 29% in the experiment and control group respectively without significant difference（P 〉0. 05）. After treatment, the serum BNP, HR, DBP and SBP significantly decreased in the two groups with significant difference（P 〈 0.05 ）, and the CO and LVEF significantly increased in the two group （P 〈 0. 05 ）. The adverse drug reactions rate were 4. 9% and 8.6% in the experiment and control group respectively without significant difference（P 〉 0. 05 ）. Conclusion Milrinone was effective and safe in the treatment of patients with in- flammatory response syndrome and heart failure .