米力农治疗慢性肺源性心脏病合并心力衰竭的临床疗效观察

摘要

目的 观察米力农治疗慢性肺源性心脏病合并心力衰竭的临床疗效.方法 46例慢性肺源性心脏病合并心力衰竭患者,随机分为常规治疗组(CT,n=23)和米力农治疗组(MT,n=23).CT组采用吸氧、抗感染、怯痰平喘等治疗,MT组在CT组治疗法方案的基础上加用米力农,7d为1疗程.观察治疗后两组6 min步行试验(6MWT)距离、脑钠肽(BNP)水平,同时采用彩色多普勒超声心动图测定静息状态下平均肺动脉压(mPAP)、心输出量(CO)的变化.结果 MT组6MWT高于CT组[(299.3±89.5)m vs.(243.2±68.8)m,P＜0.05],CO也显著高于CT组[(4.1±0.9)L/min vs.(3.6±1.3)L/min,P＜0.05]; 同时,MT组BNP低于CT组[(332±136)ng/L vs.(485±102)ng/L,P＜0.05],mPAP也低于CT组[(32.3±7.6)mmHg vs.(38.2±6.2)mmHg,P＜0.05].结论 米力农治疗可改善慢性肺源性心脏病合并心力衰竭患者的运动耐量及心功能,且可降低肺动脉压.%Objective To observe the curative effect of milrinone on chronic pulmonary heart disease ( CPHD ) complicating heart failure. Methods The patients with CPHD complicating heart failure were randomly divided into conventional treatment group ( CT group, n=23 ) and milrinone treatment group ( MT group, n=23 ) . CT group was given the treatment of oxygen uptake, anti-inflammation and Qutanping, and MT group was given milrinone besides of the same treatment as CT group. A therapeutic course was 7 days. The distance of 6-minute walk test ( 6MWT ) and level of brain natriuretic peptide ( BNP ) were observed in two groups after treatment, and changes of mean pulmonary arterial pressure ( mPAP ) and cardiac output ( CO ) in quiescent state were detected by applying color Doppler echocardiography. Results The distance of 6MWT [ ( 299.3 ± 89.5 ) m vs. ( 243.2 ± 68.8 ) m, P<0.05] and CO [ (4.1 ±0.9 ) L/min vs. ( 3.6 ± 1.3 ) L/min, P<0.05] were higher in MT group than those in CT group. At the same time, the levels of BNP [ ( 485 ± 102 ) ng/L vs. ( 332 ± 136 ) ng/L, P<0.05] and mPAP [ ( 38.2 ± 6.2 ) mmHg vs. ( 32.3 ± 7.6 ) mmHg, P<0.05] were lower in MT group than those in CT group. Conclusion Milrinone can improve the exercise tolerance and heart function, and reduce mPAP in the patients with CPHD complicating heart failure.