二联吡啶酮对慢性肺心病急性加重期患者心功能及血液流变学的影响

〖目的〗观察二联吡啶酮(米力农)对慢性肺心病急性加重期患者心功能及血液流变学的影响。〖方法〗将70例慢性肺心病急性加重期伴有心功能不全患者随机分为两组。观察组36例,在常规治疗的基础上加用米力农治疗,连续1周;对照组34例,仅予常规治疗,治疗前后以多普勒超声心动图评定心功能,并进行血液流变学检测。〖结果〗患者经米力农治疗后心排量、心脏指数、射血分数均显著增加(P<0.01)。同时血液流变学示低切变率下全血粘度、高切变率下全血粘度、血浆比粘度、红细胞聚集指数、红细胞电泳时间、红细胞比积、血小板聚集率、纤维蛋白原定量均有显著下降(P<0.01或P<0.05),其心功能与血液流变学的改善均明显优于对照组(P<0.05)。观察组临床总有效率及显效率分别94.5%及50.0%;对照组为70.6%及26.5%,观察组疗效亦明显高于对照组(P<0.05)。治疗期间未见明显副作用。〖结论〗米力农能显著改善肺心病急性加重期患者的心功能及血液流变性,是治疗肺心病的一种有效而安全的药物。

Effects of Milrinone on the Cardiac Function and Hemorrheology in Patients with Acute Exacer-bation of Chronic Pulmonary Heart Disease

Objectives To observe the effects of milrinone(Mil)on cardiac function and hemorrheology in patients with acute exacerbation ofchronic pulmonary heart disease(CPHD). Methods Seventy cases of CPHD accompanied with cardiac dysfunction during theperiod of acute exacerbation were divided randomly into observed group(36 cases)and control group(34 cases).The observed groupwas treated by routine therapy plus Mil for one week, whereas the control group was treated by routine therapy only for one week.Before and after the therapy, cardiac function was assessed by pulsed Doppler echocardiography and the parameters of hemorrheologywere detected respectively. Results In observed group, the cardiac output, cardiac index and ejection fraction increased signifi-cantly (all P<0.01). At the same time, hemorrheological tests showed that whole blood viscosity under low or high shear rate, plasmaspecific viscosity, erythrocyte aggregation index, electrophoresis time and specific volume of erythrocytes, platelets agglutinatingrate and fibrinogen contents were markedly reduced following Mil therapy(P<0.01 or P<0.05). The improvement of cardiac functionand hemorrheology was significantly better than that of the control group (P<0.05). The total clinical effective rate and obviouseffective rate in observed group were 94.5% and 50.0%, while those in control group were 70.6% and 26.5% respectively. There wasdistinct difference between both groups ( P<0.05).No severe side- effect was found in the course of Mil treatment. Conclusion Mil can obviously improve the cardiac function and hemorrheological parameters in CPHD patients with acute exacerbation. It is oneof efficient and safe drugs for treatment of pulmonary heart disease.