米力农辅助治疗顽固性心力衰竭疗效观察

目的探讨米力农辅助治疗顽固性心力衰竭的效果。方法选择顽固性心力衰竭患者60例，按住院顺序分为观察组和对照组，每组30例。对照组给予心力衰竭常规疗法，观察组在此基础上加用米力农。比较两组用药前后心功能指标、N末端脑钠尿肽前体（NT—proBNP）变化，并记录不良反应和评价疗效。结果用药后两组HR、左心室舒张末期内径（LVEDD）均显著降低（t=5．31、5．92、4．61、4．22，均P〈0．05），每搏心输出量（sV）、左心室射血分数（LVEF）及6min步行距离均显著升高（t=7．22、4．78、8．78、4．56、4．11、4．05，均P〈0．05）；观察组HR、LVEDD显著低于对照组（t=4．31、4．92，均P〈0．05），SV、LVEF及6min步行距离显著高于对照组（t=4．31、4．92、4．11，均P〈0．05）。用药后观察组NT—proBNP水平较用药前显著下降（t=14．55，P〈0．05），且显著低于对照组（t=7．12，P〈0．05）。对照组用药前后NT-proBNP水平无明显变化（t=1．03，P〉0．05）。观察组总有效率为93．33％（28／30），对照组为63．33％（19／30），差异有统计学意义（χ2=5．26，P〈0．05）。观察组出现不良反应5例，对照组出现4例，两组差异无统计学意义（χ2=0．67，P〉0．05）。结论小剂量、短期使用米力农可使顽固性心力衰竭患者的心功能得到明显改善，显著提高疗效，安全性较高。

Effect of milrinone on refractory heart failure

Objective To investigate the effects of the milrinone in adjuvant treatment of intractable heart failure. Methods 60 cases of patients with intractable heart failure were randomly divided into observation group and control group according to hospitalization sequence, 30 cases each group. The control group was given conventional therapy for heart failure, the observation group based on the use of milrinone. Changes of cardiac function index, NT-proBNP were compared between two groups before and after medication, and recorded the adverse reactions and the efficacy evaluation. Results After taking drugs, HR, LVEDD of the two groups were significantly decreased （t = 5.31,5.92,4.61,4.22, all P 〈 0.05 ）, SV, LVEF and 6 minutes walking distance increased significantly （ t = 7.22, 4. 78,8. 78,4.56,4. 11,4.05, all P 〈 0.05 ） ; group HR, LVEDD were significantly lower than those in the control group（ t = 4.31,4.92, all P 〈 0.05）. SV, LVEF and 6-minute walking distance was significantly higher than that in the control group（ t = 4.31,4.92,4.11, all P 〈 0.05 ）. After taking drugs, the observation group NT-proBNP levels decreased significantly than before treatment（ t = 14.55, P 〈 0.05 ）, and significantly lower than that in the control group （t = 7.12, P 〈 0.05 ）. No significant change in NT-proBNP levels before and after treatment in control group was found（ t = 1.03 ,P 〉0.05）. The observation group in the total effective rate was 93.33% （28/30） ,the control group was 63.33% （19/30） ,the difference was statistically significant（ χ2 = 5.26 ,P 〈 0.05 ）. 5 cases of adverse reactions to the observation group,4 patients in the control group, no significant difference in the adverse reactions was found between the two groups（χ2 = 0.67, P 〉 0.05 ）. Conclusion Low dose, short-term use of milrinone can make the heart function of patients with refractory heart failure was obviously improved, significantly improve the efficacy with higher safety.