摘要
目的：观察米力农与硝普钠联合参麦治疗急性心肌梗死（AMI）后心力衰竭的临床疗效及安全性。方法：选择我院住院治疗的AMI后出现心力衰竭患者180例,心功能均为KillipⅡ~Ⅲ级,随机分为基础治疗组、硝普钠联合参麦治疗组及米力农治疗组,每组各60例。硝普钠联合参麦组和米力农组在基础治疗上加用硝普钠和参麦或米力农治疗。硝普钠联合参麦组给予硝普钠10μg/min,缓慢静脉泵入,根据血压情况逐步上调剂量至30~50μg/min,静脉持续泵入,参麦100ml静脉滴注,1次/d,7d为1个疗程。米力农治疗组给予米力农负荷量50μg/kg,10min缓慢静脉注射,之后0.5μg/（kg·min）静脉持续泵入,7d为1个疗程。治疗前后评估患者心功能指标变化。结果：3组患者治疗后脑钠肽（BNP）、左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、心排血量（CO）、心率（HR）、中心静脉压（CVP）等指标较治疗前均有明显改善（P〈0.05,P〈0.01）,而米力农组治疗后BNP、LVEF、LVEDD、CO、HR、CVP水平明显优于基础治疗组及硝普钠联合参麦组（P〈0.05,P〈0.01）;硝普钠联合参麦组治疗后BNP、LVEF、CO、CVP水平明显优于基础治疗组（P〈0.05,P〈0.01）;硝普钠联合参麦治疗后SBP、DBP较治疗前降低（P〈0.05,P〈0.01）,而基础治疗组及米力农组治疗后SBP、DBP与治疗前比较差异无统计学意义（P〉0.05）。治疗期间,3组患者不良反应发生率及病死率差异无统计学意义（P〉0.05）。结论：米力农及硝普钠联合参麦均能有效治疗AMI后心力衰竭,而短期、小剂量持续应用米力农治疗AMI后心力衰竭更为有效。
Objective：To observe the effect and safety of milrinone and sodium nitroprusside combined shenmai in treatment of patients with heart failure after acute myocardial infarction（AMI）.Method：A total of 180 patients with acute heart failure following AMI（Killip Ⅱ ~ Ⅲ）were randomly divided into control group,sodium nitroprusside combined shenmai group and milrinone group,60 cases for each group.The sodium nitroprusside combined shenmai group was treated with general therapy and intravenous sodium nitroprusside and shenmai.The milrinone group was treated with general therapy and intravenous milrinone additonally.Sodium nitroprusside was injected initially 10μg/min by microinfusion pump,and gradually adjusted to 30~50μg/min based on the blood pressure situation.In addition,shenmai was injected 100 ml once a day,and all continued for 7days.Milrinone was injected with an initial 50μg/kg bolus in ten minutes,followed by 0.5μg/（kg·min）with micro pump intravenously for 7days as a course.The Changes of heart functional parameters before and after treatment were investigated.Result：Compared with those before treatment,the brain natriuretic peptide（BNP）,left ventricular ejection fraction（LVEF）,left ventricular end diastolic dimension（LVEDD）,cardiac output（CO）,heart rates（HR）and central venous pressure（CVP）in three groups were improved significantly after treatment（P〈0.05,P〈0.01）.However,BNP、LVEF、LVEDD、CO、HR、CVP in milrinone group were obviously improved than those in control group or sodium nitroprusside combined shenmai group after treatment（P〈0.05,P〈0.01）.BNP、LVEF、CO、CVP in sodium nitroprusside combined shenmai group were markedly improved than those in control group after treatment（P〈0.05,P〈0.01）.Although SBP and DBP in sodium nitroprusside combined shenmai grounp were significantly reduced after treatment than those before treatment（P〈0.05,P〈0.01）,they were not satistically different between control and milrinone group（P〈0
出处
《临床急诊杂志》
CAS
2015年第11期886-889,共4页
Journal of Clinical Emergency
关键词
米力农
硝普钠
参麦
急性心肌梗死
心力衰竭
milrinone
sodium nitroprusside
Shenmai
acute myocardial infarction
heart failure
