短期应用米力农治疗老年难治性心力衰竭的临床疗效

目的 观察短期应用米力农治疗老年难治性心力衰竭的临床表现、血流动力学和脑钠尿肽变化.方法 应用米力农治疗难治性心力衰竭患者20例,观察治疗前后临床表现的变化,并测定血流动力学指标和脑钠尿肽.结果 20例患者治疗后显效10例,有效6例,无效4例,总有效率为80％（16/20）.治疗前后心率、平均动脉压比较差异无统计学意义（P＞0.05）.治疗后心输出量、心脏指数均较治疗前显著提高,肺毛细血管楔压、中心静脉压较治疗前显著下降,差异均有统计学意义（P＜0.05）.治疗后脑钠尿肽较治疗前显著下降[（620.6±305.6）μg/L比（1 201.4±750.6）μg/L],差异有统计学意义（P＜0.05）.用药后2例出现恶心、不适感、室性期前收缩,经纠正低钾血症,减慢输液速度后消失.结论 米力农治疗老年难治性心力衰竭安全有效.

Short-term curative effect of milrinone in elderly refractory heart failure patients

Objective To observe the clinical effect,hemodynamic and brain natriuretic peptide changes of milrinone in the short-term treatment of elderly refractory heart failure patients.Methods Twenty elderly patients with refractory heart failure were treated with milrinone.The heart functional changes were observed before and after treatment,and hemodynamic indexes and brain natriuretic peptide were detected.Results After treatment,among 20 patients,milrinone showed excellent effect in 10 patients,utility in 6 patients,and uselessness in 4 patients.The total efficacy rate was 80% （16/20）.There were no statistical differences in heart rate and mean arterial pressure before and after treatment （P 〉 0.05）.The cardiac output and cardiac index after treatment were significantly higher than those before treatment,the pulmonary capillary wedge pressure,central venous pressure after treatment were significantly lower than those before treatment,and there were statistical differences （P 〈 0.05）.The brain natriuretic peptide after treatment was significantly lower than that before treatment [（620.6 ± 305.6） μ g/L vs.（1 201.4 ± 750.6） μ g/L],and there was statistical difference （P 〈 0.05）.After treatment,2 patients appeared nausea,disasthesia and premature ventricular contraction.When the hypokalemia was amended,these symptoms disappeared.Conclusion Milrinone has significant therapeutic effects and is safe in the treatment of elderly refractory heart failure patients.