急诊应用米力农在老年心力衰竭病人中的疗效观察

Effect of emergency application of milrinone in patients with senile heart failure

目的研究米力农(milrinone injection,MI)在治疗老年心力衰竭病人中的治疗效果并探究其在急诊的应用价值。方法选取急诊室就诊的46例老年心力衰竭病人,随机分成MI组和多巴胺(DA)组,每组23例,MI组在常规治疗的基础上进行米力农治疗,DA组在常规治疗的基础上进行DA治疗,分别观察2种方法的治疗效果以及治疗前后心率、舒张压(DBP)、收缩压(SBP)、血清脑钠肽(BNP)、左室射血分数(LVEF)和心排出量(CO)等指标的变化,并进行对比。结果与治疗前比较,2组治疗后各项心功能指标差异均有统计学意义(P<0.05)。治疗前,2组各项心功能指标比较差异无统计学意义,治疗后2组病人心率、DBP和SBP比较差异无统计学意义(P>0.05),BNP、LVEF和CO比较,差异有统计学意义(P<0.05)。MI组总有效率高于DA组,差异具有统计学意义(P<0.05)。MI组不良反应发生率低于DA组,差异具有统计学意义(P<0.05)。结论对急诊心力衰竭病人应用MI治疗,可以获得比临床常用药物DA更好的临床疗效,且安全性更高,推荐米力农在临床能得到合理的推广和使用。

Objective To study the effect of milrinone（ MI） in the treatment of elderly patients with heart failure and explore its application value in emergency. Methods Forty-six cases of elderly patients with congestive heart failure were randomly divided into two groups. 23 patients were treated with MI in the MI group on the basis of routine treatment,and another 23 patients received dopamine（ Dopamine,DA） treatment on the basis of routine treatment in DA group. Cardiac function including heart rate,diastolic blood pressure（ DBP）,systolic blood pressure（ SBP）,serum brain natriuretic peptide（ BNP）,left ventricular ejection fraction（ LVEF） and cardiac output（ CO） were observed and compared in the two groups before and after treatment. Results All the index of cardiac function were improved after treatment than those before treatment. After treatment,there was no significant difference in heart rate,DBP and SBP between the two groups（ P〉0. 05）. The levels of BNP,LVEF and CO were statistically significant（ P〈0. 05）. The total effective rate was different between group MI and group DA（ P〈0. 05）. There was significant difference in the incidence rate of adverse reactions between MI group and DA group（ P〈0. 05）. Conclusions The application of MI in the treatment of heart failure in emergency shows significant efficacy and high safety.