汤秀英.米力农与多巴酚丁胺治疗急性心肌梗死后心力衰竭临床疗效观察[J].内科急危重症杂志,2015,21(3):
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| DOI： |
| 中文关键词: 米力农 多巴酚丁胺 急性心肌梗死 心力衰竭 |
| 英文关键词:Milrinone Dobutamine Acute myocardial infarction Heart failure |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨米力农和多巴酚丁胺治疗急性心肌梗死（AMI）后急性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KillipⅢ～Ⅳ级，随机分为基础治疗组60例、多巴酚丁胺组60例与米力农组60例。多巴酚丁胺组及米力农组均在控制心力衰竭、治疗急性心肌梗死的基础治疗上加用多巴酚丁胺或米力农药物治疗；多巴酚丁胺组给予多巴酚丁胺的起始剂量为2.5ug/(kg．min-1)，随后根据血压情况上调多巴酚丁胺剂量，最大剂量用至10ug/(kg．min-1)。米力农组给予米力农负荷量50μg／kg，10 min缓慢静注，以后O．5 μg／(kg．min-1)静脉持续泵入，5 d为1个疗程。治疗前后评估患者心功能指标变化。
结果 治疗后3组患者脑钠肽（BNP）、左室射血分数（LVEF）、左室舒张末期内径（LVEDD）及心排血量（CO）等指标较治疗前均有明显改善，多巴酚丁胺、米力农对于BNP、LVEDD、LVEF和CO的影响较基础治疗明显，而米力农治疗后BNP、LVEF、HR水平的变化较多巴酚丁胺明显，均有统计学意义，治疗后3组SBP、DBP比较差异无统计学意义。治疗过程中未见明显的不良事件发生。
结论 米力农和多巴酚丁胺较基础治疗更能安全有效地改善心功能，且短期、小剂量持续应用米力农治疗AMI后心力衰竭更为有效。 |
| 英文摘要: |
| Objective To explore the efficacy and safety of milrinone and dobutamine in the treatment of heart failure patients with acute myocardial infarction
Methods A total of 180 heart failure patients with acute myocardial infarction (Killip Ⅲ-IV) were randomly divided into control group(n=60), dobutamine group(n=60) and milrinone group(n=60) The control groups received normal therapy while dobutamine group and milrinone group were intravenously injected with dobutamine or milrinone additionally. Dobutamine was given 2.5μg／(kg．min-1) initially, then could be boosted to 10μg／(kg．min-1) gradually based on blood pressure .Milrinone with an initial 50μg／(kg．min-1) bolus in ten minutes was followed by a 0.5μg／(kg．min-1) with micro pump intravenously for 5 days as a course．The changes of heart functional parameters were detected before and after treatment.
Results As compared with those before treatment, the brain natriuretic Peptide
(BNP), left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD) and cardiac output(CO)in three groups after treatment were improved significantly. BNP、LVEDD、LVEF and CO in dobutamine group and milrinone group were markedly improved compared with those in control group after treatment. BNP、LVEF and HR in milrinone group were obviously improved compared with those in dobutamine group after treatment. The clinical investigation revealed that systolic blood pressure(SBP)and diastolic blood pressure(DBP) in three groups were no statistically significant difference. There were no serious side effects.
Conclusion The administration of milrinone and dobutamine is safe and effective in the treatment of acute heart failure patients with acute myocardial infarction.The short-time ,low-dose continuous administration of milrinone is better in improving cardiac function than that of dubutamine. |
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