米力农联合低分子肝素治疗肺源性心脏病效果观察

摘要

Objective To evaluate the effect of milrinone with low molecular weight heparin treating pul -monary heart disease .Methods One hundred and twenty patients of pulmonary heart disease were divided into four groups randomly: control group , low molecular weight heparin , milrinone group and combined treatment group.Each group was given conventional therapy .Low molecular weight heparin group was treated with low mo-lecular weight heparin; milrinone group was treated with intravenous infusion of milrinone; combined treatment group was treated with intravenous infusion of milrinone and low molecular heparin .Before treatment and 10 days after treatment,analysis results of D-dimer, blood gas analysis and lung function changes .Results Ten days after treatment D-dimer, arterial pressure of carbon dioxide ( PaCO2 ) in the combined treatment group were lower than those in milrinone group, low molecular weight heparin group and control group [(0.72 ±0.34)mg/L vs (0.87 ± 0.46)mg/L,(0.85 ±0.28)mg/L,(0.99 ±0.38)mg/L;(48 ±9)mmHg vs (52 ±7)mmHg,(53 ±10)mmHg, (57 ±7) mmHg]; partial pressure of oxygen(PaO2), FEV1/predicted and FEV1/forced vital capacity(FVC) were higher than those in milrinone group , low molecular weight heparin group and control group [(73 ±5)mmHg vs (66 ±6)mmHg,(67 ±6)mmHg,(56 ±6) mmHg;(89 ±13) vs (75 ±8),(77 ±7),(69 ±10);(98 ±9) vs (81 ±10),(79 ±8),(71 ±7)].But milrinone group and low molecular weight heparin group showed no signifi -cant difference in the indicators .Conclusion Milrinone with low molecular weight heparin can reduce pulmonary arterial pressure and improve the ability of tissue to uptake and use oxygen , which can improve symptoms and signs significantly .%目的：探讨米力农联合低分子肝素治疗肺源性心脏病的效果。方法将120例慢性肺源性心脏病患者完全随机分为米力农组、低分子肝素组、联合用药组及对照组，各30例。各组均给予常规治疗，低分子肝素组加用低分子肝素、米力农组加用米力农、联合用药组加用米力农并低分子肝素治疗。治疗前和治疗10 d后对各组患者行D-二聚体、血气分析和肺功能检测。结果治疗10 d后，联合用药组D-二聚体、动脉血二氧化碳分压（ PaCO2）、动脉血氧分压（ PaO2）、第1秒用力呼气容积（ FEV1）/预计值、FEV1/用力肺活量分别为（0．72±0．34）mg/L、（48±9）mmHg（1 mmHg＝0．133 kPa）、（73±5）mmHg、（89±13）、（98±9）；米力农组分别为（0．87±0．46）mg/L、（52±7）mmHg、（67±6）mmHg、（75±8）、（81±10）；低分子肝素组分别为（0．85±0．28）mg/L、（53±10）mmHg、（66±6）mmHg、（77±7）、（79±8）；对照组分别为（0．99±0．38）mg/L、（57±7）mmHg、（56±6）mmHg、（69±10）、（71±7），联合用药组D-二聚体、动脉血二氧化碳分压明显低于其他3组，动脉血氧分压、FEV1/预计值、FEV1/用力肺活量明显高于其他3组，差异均有统计学意义（均P＜0．01）；其他3组间各项指标差异无统计学意义（P＞0．05）。结论米力农配伍低分子肝素能有效地降低肺动脉压，改善血液的黏稠度，提高组织摄取氧和利用氧的能力，从而能明显地改善患者症状和体征，具有肯定的疗效。