中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
31期
36-38
,共3页
陈欣%杨明%韩凌%赵燕%胡文泽%陈萍%马杰%孙一光
陳訢%楊明%韓凌%趙燕%鬍文澤%陳萍%馬傑%孫一光
진흔%양명%한릉%조연%호문택%진평%마걸%손일광
米力农%利钠肽,脑%心力衰竭%血流动力学
米力農%利鈉肽,腦%心力衰竭%血流動力學
미력농%리납태,뇌%심력쇠갈%혈류동역학
Milrinone%Natriuretic peptide,brain%Heart failure%Hemodynamics
目的 观察短期应用米力农治疗老年难治性心力衰竭的临床表现、血流动力学和脑钠尿肽变化.方法 应用米力农治疗难治性心力衰竭患者20例,观察治疗前后临床表现的变化,并测定血流动力学指标和脑钠尿肽.结果 20例患者治疗后显效10例,有效6例,无效4例,总有效率为80%(16/20).治疗前后心率、平均动脉压比较差异无统计学意义(P>0.05).治疗后心输出量、心脏指数均较治疗前显著提高,肺毛细血管楔压、中心静脉压较治疗前显著下降,差异均有统计学意义(P<0.05).治疗后脑钠尿肽较治疗前显著下降[(620.6±305.6)μg/L比(1 201.4±750.6)μg/L],差异有统计学意义(P<0.05).用药后2例出现恶心、不适感、室性期前收缩,经纠正低钾血症,减慢输液速度后消失.结论 米力农治疗老年难治性心力衰竭安全有效.
目的 觀察短期應用米力農治療老年難治性心力衰竭的臨床錶現、血流動力學和腦鈉尿肽變化.方法 應用米力農治療難治性心力衰竭患者20例,觀察治療前後臨床錶現的變化,併測定血流動力學指標和腦鈉尿肽.結果 20例患者治療後顯效10例,有效6例,無效4例,總有效率為80%(16/20).治療前後心率、平均動脈壓比較差異無統計學意義(P>0.05).治療後心輸齣量、心髒指數均較治療前顯著提高,肺毛細血管楔壓、中心靜脈壓較治療前顯著下降,差異均有統計學意義(P<0.05).治療後腦鈉尿肽較治療前顯著下降[(620.6±305.6)μg/L比(1 201.4±750.6)μg/L],差異有統計學意義(P<0.05).用藥後2例齣現噁心、不適感、室性期前收縮,經糾正低鉀血癥,減慢輸液速度後消失.結論 米力農治療老年難治性心力衰竭安全有效.
목적 관찰단기응용미력농치료노년난치성심력쇠갈적림상표현、혈류동역학화뇌납뇨태변화.방법 응용미력농치료난치성심력쇠갈환자20례,관찰치료전후림상표현적변화,병측정혈류동역학지표화뇌납뇨태.결과 20례환자치료후현효10례,유효6례,무효4례,총유효솔위80%(16/20).치료전후심솔、평균동맥압비교차이무통계학의의(P>0.05).치료후심수출량、심장지수균교치료전현저제고,폐모세혈관설압、중심정맥압교치료전현저하강,차이균유통계학의의(P<0.05).치료후뇌납뇨태교치료전현저하강[(620.6±305.6)μg/L비(1 201.4±750.6)μg/L],차이유통계학의의(P<0.05).용약후2례출현악심、불괄감、실성기전수축,경규정저갑혈증,감만수액속도후소실.결론 미력농치료노년난치성심력쇠갈안전유효.
Objective To observe the clinical effect,hemodynamic and brain natriuretic peptide changes of milrinone in the short-term treatment of elderly refractory heart failure patients.Methods Twenty elderly patients with refractory heart failure were treated with milrinone.The heart functional changes were observed before and after treatment,and hemodynamic indexes and brain natriuretic peptide were detected.Results After treatment,among 20 patients,milrinone showed excellent effect in 10 patients,utility in 6 patients,and uselessness in 4 patients.The total efficacy rate was 80% (16/20).There were no statistical differences in heart rate and mean arterial pressure before and after treatment (P > 0.05).The cardiac output and cardiac index after treatment were significantly higher than those before treatment,the pulmonary capillary wedge pressure,central venous pressure after treatment were significantly lower than those before treatment,and there were statistical differences (P < 0.05).The brain natriuretic peptide after treatment was significantly lower than that before treatment [(620.6 ± 305.6) μ g/L vs.(1 201.4 ± 750.6) μ g/L],and there was statistical difference (P < 0.05).After treatment,2 patients appeared nausea,disasthesia and premature ventricular contraction.When the hypokalemia was amended,these symptoms disappeared.Conclusion Milrinone has significant therapeutic effects and is safe in the treatment of elderly refractory heart failure patients.