不同剂量米力农对新生儿肺动脉高压的疗效及肝肾功能的影响

Curative effect of different doses of milrinone in treatment with pulmonary hypertension in newborns and its effect on liver and kidney function

目的探讨不同剂量米力农对新生儿肺动脉高压(PPHN)的疗效及肝肾功能的影响。方法将2013年5月—2017年6月收治的96例肺动脉高压新生儿均分为A、B、C 3组,在常规治疗的基础上应用米力农注射液治疗,3组维持剂量分别为0.25、0.50、0.75μg/(kg?min)。比较3组的血气指标、疗效和肝肾功能指标。结果 3组治疗后的肺动脉血氧饱和度(Sp O2)、氧分压(Pa O2)高于治疗前且二氧化碳分压(Pa CO2)、肺动脉收缩压(PASP)低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);且C组的改善幅度大于A、B组,差异有统计学意义(P<0.05);A组的改善幅度小于B组,差异有统计学意义(P<0.05)。经治疗,C组的总有效率高于A、B两组,差异有统计学意义(P<0.05);A组总有效率低于B组,差异有统计学意义(P<0.05)。3组治疗后的丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、尿素氮(BUN)和血肌酐(Scr)与治疗前差异无统计学意义,且治疗前后组间差异无统计学意义。结论在常规治疗的基础上应用米力农治疗PPHN可明显改善血气指标,疗效显著,无肝肾功能损伤及其他不良反应,最佳维持剂量为0.75μg/(kg?min)。但有必要扩大样本量以对合适的剂量做进一步系统研究。

Objective To discuss the curative effect of different doses of milrinone in treatment with pulmonary hypertension in newborns（PPHN） and its effect on liver and kidney function. Methods A total of 96 pulmonary hypertension newborns treated in our hospital from May 2013 to June 2017 were divided into group A, B and C on the basis of routine therapy. The maintenance dose of milrinone for three groups were 0.25, 0.50, and 0.75 μg/（kg？min）, respectively. The blood gas index, curative effect and liver and kidney function indexes of the three groups were compared. Results After treatment, Sp O2, Pa O2 and Pa CO2 and PASP of three groups were lower than those before（P〈0.05）, and the improvement of group C was greater than that of group A and group B（P〈0.05）, the improvement of group A was less than that of group B（P〈0.05）. After treatment, the total effective difference between the three groups was statistically significant（P〈0.05）, and the total effective rate of group C was higher than that of group A and B（P〈0.05）, and the total effective rate of group A was lower than that of group B（P〈0.05）. There was no statistically significant difference in ALT, AST, BUN and Scr after treatment among three groups, and there was no significant difference of three groups before and after treatment. Conclusion On the basis of conventional treatment, milrinone in treatment with PPHN can obviously improve the blood gas index and the efficacy is remarkable, it shows no liver and kidney function injury and other adverse reactions. And the optimal maintenance dose is 0.75 μg/（kg？min）. However, it is necessary to enlarge the sample size to study the appropriate dosagefurtherly.