米力农治疗冠状动脉旁路移植术后左室功能障碍的短期疗效

目的：评价米力农对冠状动脉搭桥术（CABG）中左室功能障碍患者短期疗效。方法：62例CABG术后低心排患者（左心室射血分数〈35％）纳入该研究。将患者随机分为米力农组[n=31，米力农（50μg／kg）静脉注射并于术后24h0．5μg／（kg·min）持续泵入]和对照组（n=31，生理盐水作为安慰剂）。左室功能障碍采用血流动力学参数和经胸廓的超声心动图进行评估。结果：两组患者的基线水平有差异，术前米力农组患者的左心室射血分数低于对照组，术后两组无明显差异。米力农组的血清肌酸磷酸激酶（CK）及其同工酶（CK—MB）、发生心肌缺血或梗死和应用正性肌力药物的时间均显著低于对照组（P〈0．05，P〈0．01）。室性心律失常、使用主动脉内球囊反博的时间、机械通气和24h病死率两组无明显差异。结论：对于接受CABG，尤其是左室射血分数较低的的患者，应用米力农可以减少心肌梗死发生的风险和应用正性肌力药物支持的时间。

Effect of milrinone on dysfunction undergoing short-term outcome of coronary artery bypass patients with myocardial graft

AIM： To evaluate the effect of milrinone on patients with ventricular dysfunction undergoing coronary artery bypass graft （CABG）. METHODS： Sixty-two patients with impaired left ventricular function [ left ventrieular ejection fraction （LVEF） 〈 35% ] undergoing CABG were enrolled. Patients were randomized to receive either an intraoperative bolus of milrinone （50 μg/kg） or saline as followed by a 24-h infusion of each echocardiographic measurement of placebo, agent [0. 5 μg/（kg ·min）]. Hemodynamic parameters and transthoracic systolic and diastolic functions were evaluated. RESULTS： Serum levels of creatine phosphokinase （CPK）, MB isoenzyme of creatine kinase （CK-MB）, occurrence of myocardial ischemia or infarction, and mean duration of using inotropic agents were significantly lower in the milrinone group （P 〈0. 05, P 〈0. 01 ）. There were no significant differences between groups in the development of ventricular arrhythmia, intra-aortic balloon pump and inotropic support requirement, duration of mechanical ventilation and 24-h mortality rate. Although mean preoperative LVEF was significantly lower in milrinone group, there was no significant difference in postoperative LVEFs. CONCLUSION： We suggest perioperative administration of milrinone in patients undergoing CABG, especially in those with low LVEF.