盐酸奥普力农治疗充血性心力衰竭的疗效及安全性评价

摘要

Objective To evaluate the efficacy and safety of Olprinone in treatment of congestive heart failure(CHF).Methods 94 cases of CHF were randomly divided into Olprinone group and Milrinone group,47 cases in each group.Olprinone or Milrinone were prescribed for patients of two groups respectively.The change of NT-proBNP level,cardiac function measured by echocardiography including left ventricular ejection fraction(LVEF),fractional shortening(FS),left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic diameter(LVESD),left ventricular end systolic volume(LVESV),cardiac output(CO) and cardiac index(CI) after 7 days' treatment and short-term prognosis were observed.Results NT-proBNP level,LVEDV of two groups decreased significantly(P =0.000,0.013 respectively in Olprinone group,P =0.000,0.014 respectively in Milrinone group),and LVEF and FS increased significantly(P =0.000,0.011 respectively in Olprinone group,P =0.030,0.042 respectively in Milrinone group).After 7 days' treatment,compared with Milrinone group,NT-proBNP level of Olprinone group was lower (P =0.041),and LVEF and FS were higher(P =0.048,0.047 respectively).There were no significant differences between PLT level,liver function and renal function of the two groups.The mortality of 7-day and 30-day of Olprinone group was not significantly different from that of Milrinone group.Conclusions Olprinone is better than Milrinone in the effect of depressing NT-proBNP level and improving cardiac function.Meanwhile,the incidence of side effect does not appear to be higher.%目的 评价盐酸奥普力农治疗充血性心力衰竭(CHF)临床疗效及不良反应.方法 采用随机分组的方法,将94例充血性心衰患者分为奥普力农组(试验组)和米力农组(对照组),每组47例,分别予奥普力农与米力农静脉用药,观察治疗7天后血清N端前体脑钠肽(NT-proBNP)和超声心动图测量下的左心室射血分数(LVEF)、短轴缩短率(FS)、左室舒张末期直径(LVEDD)及容积(LVEDV)、收缩末期直径(LVESD)、容积(LVESV)、心排血量(C0)与心脏指数(CI)等心功能变化情况及短期预后.结果 治疗7天后,两组患者血清NT-proBNP、LVEDV均较治疗前明显下降(试验组两者P值分别为0.000,0.013;对照组两者P值分别为0.000,0.014),LVEF及FS较治疗前明显升高(试验组两者P值分别为0.000,0.011；对照组两者P值分别为0.030,0.042).治疗后两组间比较,试验组NT-proBNP浓度较对照组更低(P=0.041),LVEF及FS较对照组更高(P值分别为0.048,0.047).两组患者治疗前后血小板(PLT)及肝肾功能改变均无统计学意义(P＞0.05).两组患者7天及30天死亡率之间的差异均无统计学意义(P＞0.05).结论 奥普力农可使CHF病人NT-proBNP下降、心功能改善,疗效明显优于米力农,而不良反应并不增加.