米力农联合西地兰治疗婴幼儿重症肺炎合并心力衰竭的临床疗效分析

Clinical Efficacy of Milrinone Combined with Cedilan in the Treatment of Infants with Severe Pneumonia Complicated with Heart Failure

目的:探讨米力农联合西地兰治疗婴幼儿重症肺炎合并心力衰竭的临床疗效。方法:纳入2016年4月—2018年4月我院收治婴幼儿重症肺炎合并心力衰竭患儿90例,按随机数字表分为三组(米力农组、西地兰组及联合用药组,各30例),三组患儿均予以基础治疗,米力农组患儿加用米力农注射液,西地兰组加用西地兰注射液,联合用药组同时予以米力农及西地兰进行治疗。比较三组患儿的临床疗效、临床症状消失时间、治疗前后心功能相关指标及不良反应发生情况的差异。结果:联合用药组整体治疗有效率明显高于米力农组及西地兰组(P<0.05),米力农组与西地兰组之间治疗有效率差异无统计学意义(P>0.05)。联合用药组临床症状消失时间(烦躁消除时间、心率好转时间及住院时间)明显较米力农组及西地兰组缩短(P<0.05),米力农组及西地兰组之间上述指标差异无统计学意义(P>0.05)。治疗前三组左心射血分数、左室收缩功能及NT-proBNP差别无明显统计学意义,与治疗前相比,三组治疗后左心射血分数及左室收缩功能显著升高,NT-proBNP水平显著降低,其中联合用药组上述指标变化最为显著(P<0.05),米力农组及西地兰组之间差异无统计学意义(P>0.05)。三组均未出现明显不良反应。结论:米力农联合西地兰治疗重症肺炎合并心力衰竭婴幼儿患儿,在显著改善心功能和临床症状的同时不增加不良反应的发生率,值得临床推广。

Objective:To investigate the clinical efficacy of milrinone combined with cedilan in the treatment of severe pneumonia complicated with heart failure in infants and young children.Methods:From April 2016 to April 2018,90 children with severe pneumonia complicated with heart failure in our hospital were randomly divided into 3 groups according to the random number table(milinong group,cedilan group and combination medication group,30 cases each),children of three groups were treated with basic treatment,milrinone group patients were given extra milrinone injection,cedilan group patients were given extra cedilan injection,combined medication group patients were given extra milrinone and cedilan injection.The clinical efficacy,the disappearance time of clinical symptoms,the related indexes of cardiac function before and after treatment,and the incidence of adverse reactions were compared between the three groups.Results:The overall treatment efficiency of the combination medication group was significantly better than that of the milianon group and the cedilan group(P<0.05).There was no significant difference in the treatment efficiency between the Milianon group and the cedilan group(P>0.05).The time of clinical symptom disappearance in the combination group(the time of irritability elimination,the time of heart rate improvement and the length of hospital stay)were significantly shorter than those of the milrinone group and the cedilan group(P<0.05).There was no statistically significant difference between the milrinone group and the cedilan group of those time(P>0.05).There was no significant difference in left ventricular ejection fraction,left ventricular systolic function and NT-proBNP between the three groups before treatment.Compared with before treatment,the left ventricular ejection fraction and left ventricular systolic function was significantly increased while the NT-proBNP level was significantly decreased in the three groups.The changes of the combination medication group was the most significant(P<0.05).There was no significant difference between the milrinone group and the cedilan group(P>0.05).No significant adverse reactions occurred in the three groups.Conclusion:Milrinone combined with cedilan in the treatment of severe pneumonia complicated with heart failure in infants and young children,significantly improve the heart function and clinical symptoms without increasing the adverse reaction rate,it is worthy of clinical promotion.