摘要
目的：探讨米力农联合低分子肝素治疗肺源性心脏病的效果。方法将120例慢性肺源性心脏病患者完全随机分为米力农组、低分子肝素组、联合用药组及对照组，各30例。各组均给予常规治疗，低分子肝素组加用低分子肝素、米力农组加用米力农、联合用药组加用米力农并低分子肝素治疗。治疗前和治疗10 d后对各组患者行D-二聚体、血气分析和肺功能检测。结果治疗10 d后，联合用药组D-二聚体、动脉血二氧化碳分压（ PaCO2）、动脉血氧分压（ PaO2）、第1秒用力呼气容积（ FEV1）/预计值、FEV1/用力肺活量分别为（0．72±0．34）mg/L、（48±9）mmHg（1 mmHg＝0．133 kPa）、（73±5）mmHg、（89±13）、（98±9）；米力农组分别为（0．87±0．46）mg/L、（52±7）mmHg、（67±6）mmHg、（75±8）、（81±10）；低分子肝素组分别为（0．85±0．28）mg/L、（53±10）mmHg、（66±6）mmHg、（77±7）、（79±8）；对照组分别为（0．99±0．38）mg/L、（57±7）mmHg、（56±6）mmHg、（69±10）、（71±7），联合用药组D-二聚体、动脉血二氧化碳分压明显低于其他3组，动脉血氧分压、FEV1/预计值、FEV1/用力肺活量明显高于其他3组，差异均有统计学意义（均P＜0．01）；其他3组间各项指标差异无统计学意义（P＞0．05）。结论米力农配伍低分子肝素能有效地降低肺动脉压，改善血液的黏稠度，提高组织摄取氧和利用氧的能力，从而能明显地改善患者症状和体征，具有肯定的疗效。
Objective To evaluate the effect of milrinone with low molecular weight heparin treating pul -monary heart disease .Methods One hundred and twenty patients of pulmonary heart disease were divided into four groups randomly： control group , low molecular weight heparin , milrinone group and combined treatment group.Each group was given conventional therapy .Low molecular weight heparin group was treated with low mo-lecular weight heparin; milrinone group was treated with intravenous infusion of milrinone; combined treatment group was treated with intravenous infusion of milrinone and low molecular heparin .Before treatment and 10 days after treatment,analysis results of D-dimer, blood gas analysis and lung function changes .Results Ten days after treatment D-dimer, arterial pressure of carbon dioxide （ PaCO2 ） in the combined treatment group were lower than those in milrinone group, low molecular weight heparin group and control group [（0.72 ±0.34）mg/L vs （0.87 ± 0.46）mg/L,（0.85 ±0.28）mg/L,（0.99 ±0.38）mg/L;（48 ±9）mmHg vs （52 ±7）mmHg,（53 ±10）mmHg, （57 ±7） mmHg]; partial pressure of oxygen（PaO2）, FEV1/predicted and FEV1/forced vital capacity（FVC） were higher than those in milrinone group , low molecular weight heparin group and control group [（73 ±5）mmHg vs （66 ±6）mmHg,（67 ±6）mmHg,（56 ±6） mmHg;（89 ±13） vs （75 ±8）,（77 ±7）,（69 ±10）;（98 ±9） vs （81 ±10）,（79 ±8）,（71 ±7）].But milrinone group and low molecular weight heparin group showed no signifi -cant difference in the indicators .Conclusion Milrinone with low molecular weight heparin can reduce pulmonary arterial pressure and improve the ability of tissue to uptake and use oxygen , which can improve symptoms and signs significantly .
出处
《中国医药》
2014年第9期1286-1288,共3页
China Medicine
关键词
肺心病
米力农
低分子肝素
D-二聚体
Pulmonary heart disease
Milrinone
Low molecular weight heparin
D-dimer
