地高辛联合米力农对先心病合并心力衰竭患儿心功能及血清BNP、ADMA、cTnI水平的影响

Effects of Digoxin Combined with Milrinone on Heart Function and Serum BNP,ADMA,cTnI Levels in Children with Congenital Heart Disease and Heart Failure

目的研究地高辛联合米力农对先天性心脏病(先心病)合并心力衰竭患儿心功能及血清脑钠肽(BNP)、不对称二甲精氨酸(ADMA)、心肌肌钙蛋白I(cTnI)水平的影响。方法选取100例茂名市妇幼保健院于2018年5月—2020年7月收治的先天性心脏病合并心力衰竭患儿,依据随机数字表法分为对照组和研究组,各50例。对照组给予地高辛治疗,研究组联合米力农治疗,两组患儿治疗周期为7 d。比较两组患儿治疗后临床疗效,治疗前后心功能指标左心室身血分数(LVEF)、左心室收缩期内径(LVSTI)、右心室收缩期内缩(RVSTI)及血清BNP、ADMA、cTnI水平。结果研究组总有效率为94.00%,高于对照组的78.00%,差异有统计学意义(χ^(2)=5.316,P<0.05);与治疗前相比,治疗后两组患儿LVSTI、RVSTI均降低,且研究组低于对照组,差异有统计学意义(t=6.063、1.996,P<0.05),而LVEF均升高,且研究组高于对照组,差异有统计学意义(t=5.702,P<0.05);治疗后两组患儿血清BNP、ADMA、cTnI水平均降低,且研究组低于对照组,差异有统计学意义(t=18.380、7.047、3.162,P<0.05)。结论地高辛联合米力农可有效减缓先天性心脏病合并心力衰竭患儿的临床症状,改善心功能,降低血清BNP、ADMA、cTnI水平,提升治疗效果。

Objective To study the effect of digoxin combined with milrinone on heart function and serum BNP,ADMA,cTnI levels in children with congenital heart disease complicated with heart failure.Methods A total of 100 children with congenital heart disease and heart failure admitted to Maoming Maternity and Child Health Hospital from May 2018 to July 2020 were selected.They were divided into a control group and a study group according to the random number table method,with 50 cases in each group.The control group was treated with digoxin,and the study group was treated with milrinone.The treatment cycle of the two groups was 7 days.The clinical efficacy of the two groups of children after treatment were compared,the cardiac function indexes LVEF,LVSTI,RVSTI and serum BNP,ADMA,cTnI levels before and after treatment were compared.Results The total effective rate of the study group was 94.00%,which was higher than 78.00%of the control group,the difference was statistically significant(χ^(2)=5.316,P<0.05);compared with before treatment,the LVSTI and RVSTI of the two groups of children decreased after treatment,and the study group was lower than the control group,the difference was statistically significant(t=6.063,1.996,P<0.05),and LVEF increased,and the study group was higher than the control group,the difference was statistically significant(t=5.702,P<0.05);after treatment,the serum BNP,ADMA,cTnI levels of the two groups of children decreased,and the study group was lower than the control group,the difference was statistically significant(t=18.380,7.047,3.162,P<0.05).Conclusion Digoxin combined with milrinone can effectively alleviate the clinical symptoms of children with congenital heart disease and heart failure,improve heart function,reduce serum BNP,ADMA,and cTnI levels,and enhance the therapeutic effect.