米力农治疗顽固性充血性心力衰竭的临床研究

Clinical research of milrinone in the treatment of refractory congestive heart failure

目的探讨米力农治疗顽固性充血性心力衰竭的临床疗效及安全性。方法 98例顽固性充血性心力衰竭患者,依据治疗方法不同分为研究组与对照组,各49例。对照组在常规治疗的基础上采用多巴酚丁胺治疗,研究组在常规治疗的基础上采用米力农治疗。比较两组临床总有效率及治疗前后心率(HR)、N末端脑钠肽前体(NT-pro BNP)、左室射血分数(LVEF)及心输出量(CO)的差异。结果研究组临床总有效率为93.9%,明显优于对照组的67.3%(P<0.05)。用药后7 d,两组HR[(90±14)、(92±13)次/min]、NT-pro BNP[(5276±997)、(9636±1013)ng/L]、LVEF[(44.1±7.4)、(37.3±5.6)%]、CO[(4.3±0.5)、(3.8±1.0)L/(min·m^2)]均较治疗前有明显改善(P<0.05),且研究组明显优于对照组(P<0.05)。结论米力农能有效改善充血性心力衰竭患者的临床症状,改善患者的心功能及心输出量,可供临床参考与应用。

Objective To investigate clinical effect and safety by milrinone in the treatment of refractory congestive heart failure. Methods A total of 98 patients with refractory congestive heart failure were divided by different treatment measures into research group and control group, with 49 cases in each group. The control group received additional dobutamine to conventional therapy, and the research group received additional milrinone to conventional therapy. Comparison was made on total clinical effective rate, heart rate（HR）, N-terminal pro-brain natriuretic peptide（NT-pro BNP）, left ventricular ejection fraction（LVEF） and cardiac output（CO） before and after treatment between the two groups. Results The research group had obviously better total clinical effective rate as 93.9% than 67.3% of the control group（P〈0.05）. After 7 d of drug administration, both groups had better HR [（90±14） and（92±13） times/min], NT-pro BNP [（5276±997） and（9636±1013） ng/L], LVEF [（44.1±7.4） and（37.3±5.6）%] and CO [（4.3±0.5） and（3.8±1.0） L/（min·m^2）] than those before treatment（P〈0.05）. The research group had much better improvement than the control group（P〈0.05）. Conclusion Milrinone can effectively improve clinical symptoms in refractory congestive heart failure patients, along with improved cardiac function and cardiac output. It can be taken into clinical reference and application.