米力农治疗糖尿病心脏病的临床疗效及其对患者心肌收缩力和氧供的影响

Clinical Effect of Milrinone in the Treatment of Diabetic Cardiopathy and Its Impact on Myocardial Contractility and Oxygen Supply

背景米力农在治疗慢性心力衰竭、肺源性心脏病方面具有一定效果,但国内关于其治疗糖尿病心脏病(DC)的研究较少。目的探讨米力农治疗DC的临床疗效及其对患者心肌收缩力和氧供的影响,以为临床治疗提供数据支持。方法选取中国医学科学院阜外医院深圳医院2018年9月—2019年9月收治的DC患者74例,按照随机数字表法分为对照组和研究组,各37例。对照组患者采用二甲双胍治疗,研究组患者在对照组基础上采用米力农注射液治疗,两组患者均以5 d为1个疗程,每个月治疗1个疗程,持续治疗6个月。比较两组患者治疗前及治疗后3、6个月空腹血糖,治疗后6个月纽约心脏病协会(NYHA)心功能分级及临床疗效,治疗前、治疗后6个月心肌收缩力指标、氧输送(DO2),并观察患者治疗期间不良反应发生情况。结果研究组患者治疗后3、6个月空腹血糖低于对照组(P<0.05)。研究组患者治疗后6个月NYHA心功能分级、临床疗效优于对照组(P<0.05)。研究组患者治疗后6个月心排血量(CO)、心脏每搏量(SV)、心脏指数(CI)、左心室射血分数(LVEF)、DO2高于对照组(P<0.05)。两组患者治疗期间均未出现严重不良反应。结论米力农治疗DC的临床疗效确切,可有效改善患者的临床症状,增强患者心肌收缩力及心功能,维持机体氧供平衡,且安全性高。

Background Milrinone has a certain effect in the treatment of chronic heart failure and pulmonary heart disease,but there is no relevant research in the treatment of diabetic cardiopathy(DC)in China.Objective To explore the clinical effect of milrinone in the treatment of DC and its impact on myocardial contractility and oxygen supply of patients,in order to provide data support for clinical treatment.Methods 74 cases of patients with DC in Shenzhen Hospital,Fuwai Hospital,Chinese Academy of Medical Sciences from September 2018 to September 2019 were selected,and they were divided into control group and study group according to the random number table method,37 cases in each group.Patients in control group were treated with metformin,patients in study group were treated with milrinone injection on the basis of the control group,5 days as 1 course in both groups,and per month 1 course,and continuously treated for 6 months.FBG before treatment and 3,6 months after treatmnet,NYHA cardiac functional grading and clinical effect 6 months after treatmnet,myocardial contractility indexes and DO2 before treatment and 6 months after treatment were compared between the two groups,and the incidence of adverse reactions during the treatment of the two groups were observed.Results The FBG in study group was lower than that in control group at 3,6 months after treatment(P<0.05).NYHA cardiac functional grading and clinical effect in study group were better than those in control group at 6 months after treatment(P<0.05).The CO,SV,CI,LVEF,DO2 in study group were higher than those in control group at 6 months after treatment(P<0.05).No serious adverse reactions occurred during the treatment of the two groups.Conclusion Milrinone has an exact clinical effect in the treatment of DC,which can improve clinical symptoms of patients,strengthen myocardial contractility and cardiac function,maintain the balance of oxygen supply,and with high safety.