中国医药
中國醫藥
중국의약
China Medicine
2015年
9期
1271-1274
,共4页
充血性心力衰竭%奥普力农%米力农
充血性心力衰竭%奧普力農%米力農
충혈성심력쇠갈%오보력농%미력농
Congestive heart failure%Olprinone%Milrinone
目的 评价盐酸奥普力农注射液治疗充血性心力衰竭(CHF)的有效性和安全性.方法 选择2009年4月至2010年5月在扬州市第一人民医院心内科确诊为CHF的患者52例,采用随机数字表法分成观察组(26例)和对照组(26例).观察组给予盐酸奥普力农注射液治疗,对照组给予米力农注射液治疗.采用超声心动图检测治疗前后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左心房内径,记录心胸比、肝肾功能、血尿常规、心电图,记录患者用药期间的一般状况及心功能评分,并记录不良反应.随访出院后6个月心血管事件发生情况(恶化、再住院、死亡).结果 根据纽约心脏病学会心功能疗效评分,观察组总有效率为88.5％(23/26),对照组总有效率为84.6％(22/26);按Boston心功能疗效评分,观察组总有效率为61.5％ (16/26),对照组总有效率为57.7％ (15/26);2组疗效比较差异均无统计学意义(均P＞0.05).2组治疗后心率、收缩压、Boston评分、LVEF、LVEDV、LVESV、LVFS与治疗前比较均明显改善[观察组:(73±10)次/min比(94±26)次/min,(120±11)mmHg(1 mmHg=0.133 kPa)比(128±19) mmHg,(5.4±1.7)分比(9.9±1.3)分,(47±11)％比(41±11)％,(222±74) ml比(236±75) ml,(118±57) ml比(138±67) ml,(27±8) mm比(23±8)mm;对照组:(76±11)次/min比(100 ±30)次/min,(119±10) mmHg比(127 ± 21) mmHg,(5.7±1.6)分比(9.8±1.0)分,(47±19)％比(43±7)％,(218±67) ml比(231 ±69) ml,(116±50) ml比(133±55) ml,(25±5) mm比(22±4)mm](均P＜0.05),舒张压、心胸比、LVEDD、LVSDD、左心房内径与治疗前比较差异无统计学意义(P＞0.05).观察组治疗后血红蛋白水平和血小板计数明显高于治疗前[(141±22) g/L比(139±19) g/L,(184±67)×109/L比(160±61)×109/L],对照组治疗后血红蛋白水平均明显高于治疗前[(138±13) g/L比(133±13) g/L] (P ＜0.05).观察组和对照组治疗后肝肾功能指标无明显改变(P＞0.05).2组间治疗前后心功能、生化指标和肝肾功能指标比较差异均无统计学意义(均P＞0.05).对照组和观察组不良反应发生率比较,差异无统计学意义(P＞0.05).随访6个月,对照组7例、观察组6例心力衰竭恶化,差异无统计学意义(P＞0.05).结论 盐酸奥普力农短期应用能有效缓解心力衰竭的临床症状,对肝肾功能无明显不良影响.
目的 評價鹽痠奧普力農註射液治療充血性心力衰竭(CHF)的有效性和安全性.方法 選擇2009年4月至2010年5月在颺州市第一人民醫院心內科確診為CHF的患者52例,採用隨機數字錶法分成觀察組(26例)和對照組(26例).觀察組給予鹽痠奧普力農註射液治療,對照組給予米力農註射液治療.採用超聲心動圖檢測治療前後左心室舒張末期內徑(LVEDD)、左心室收縮末期內徑(LVESD)、左心室舒張末期容積(LVEDV)、左心室收縮末期容積(LVESV)、左心室射血分數(LVEF)、左心室短軸縮短率(LVFS)、左心房內徑,記錄心胸比、肝腎功能、血尿常規、心電圖,記錄患者用藥期間的一般狀況及心功能評分,併記錄不良反應.隨訪齣院後6箇月心血管事件髮生情況(噁化、再住院、死亡).結果 根據紐約心髒病學會心功能療效評分,觀察組總有效率為88.5％(23/26),對照組總有效率為84.6％(22/26);按Boston心功能療效評分,觀察組總有效率為61.5％ (16/26),對照組總有效率為57.7％ (15/26);2組療效比較差異均無統計學意義(均P＞0.05).2組治療後心率、收縮壓、Boston評分、LVEF、LVEDV、LVESV、LVFS與治療前比較均明顯改善[觀察組:(73±10)次/min比(94±26)次/min,(120±11)mmHg(1 mmHg=0.133 kPa)比(128±19) mmHg,(5.4±1.7)分比(9.9±1.3)分,(47±11)％比(41±11)％,(222±74) ml比(236±75) ml,(118±57) ml比(138±67) ml,(27±8) mm比(23±8)mm;對照組:(76±11)次/min比(100 ±30)次/min,(119±10) mmHg比(127 ± 21) mmHg,(5.7±1.6)分比(9.8±1.0)分,(47±19)％比(43±7)％,(218±67) ml比(231 ±69) ml,(116±50) ml比(133±55) ml,(25±5) mm比(22±4)mm](均P＜0.05),舒張壓、心胸比、LVEDD、LVSDD、左心房內徑與治療前比較差異無統計學意義(P＞0.05).觀察組治療後血紅蛋白水平和血小闆計數明顯高于治療前[(141±22) g/L比(139±19) g/L,(184±67)×109/L比(160±61)×109/L],對照組治療後血紅蛋白水平均明顯高于治療前[(138±13) g/L比(133±13) g/L] (P ＜0.05).觀察組和對照組治療後肝腎功能指標無明顯改變(P＞0.05).2組間治療前後心功能、生化指標和肝腎功能指標比較差異均無統計學意義(均P＞0.05).對照組和觀察組不良反應髮生率比較,差異無統計學意義(P＞0.05).隨訪6箇月,對照組7例、觀察組6例心力衰竭噁化,差異無統計學意義(P＞0.05).結論 鹽痠奧普力農短期應用能有效緩解心力衰竭的臨床癥狀,對肝腎功能無明顯不良影響.
목적 평개염산오보력농주사액치료충혈성심력쇠갈(CHF)적유효성화안전성.방법 선택2009년4월지2010년5월재양주시제일인민의원심내과학진위CHF적환자52례,채용수궤수자표법분성관찰조(26례)화대조조(26례).관찰조급여염산오보력농주사액치료,대조조급여미력농주사액치료.채용초성심동도검측치료전후좌심실서장말기내경(LVEDD)、좌심실수축말기내경(LVESD)、좌심실서장말기용적(LVEDV)、좌심실수축말기용적(LVESV)、좌심실사혈분수(LVEF)、좌심실단축축단솔(LVFS)、좌심방내경,기록심흉비、간신공능、혈뇨상규、심전도,기록환자용약기간적일반상황급심공능평분,병기록불량반응.수방출원후6개월심혈관사건발생정황(악화、재주원、사망).결과 근거뉴약심장병학회심공능료효평분,관찰조총유효솔위88.5％(23/26),대조조총유효솔위84.6％(22/26);안Boston심공능료효평분,관찰조총유효솔위61.5％ (16/26),대조조총유효솔위57.7％ (15/26);2조료효비교차이균무통계학의의(균P＞0.05).2조치료후심솔、수축압、Boston평분、LVEF、LVEDV、LVESV、LVFS여치료전비교균명현개선[관찰조:(73±10)차/min비(94±26)차/min,(120±11)mmHg(1 mmHg=0.133 kPa)비(128±19) mmHg,(5.4±1.7)분비(9.9±1.3)분,(47±11)％비(41±11)％,(222±74) ml비(236±75) ml,(118±57) ml비(138±67) ml,(27±8) mm비(23±8)mm;대조조:(76±11)차/min비(100 ±30)차/min,(119±10) mmHg비(127 ± 21) mmHg,(5.7±1.6)분비(9.8±1.0)분,(47±19)％비(43±7)％,(218±67) ml비(231 ±69) ml,(116±50) ml비(133±55) ml,(25±5) mm비(22±4)mm](균P＜0.05),서장압、심흉비、LVEDD、LVSDD、좌심방내경여치료전비교차이무통계학의의(P＞0.05).관찰조치료후혈홍단백수평화혈소판계수명현고우치료전[(141±22) g/L비(139±19) g/L,(184±67)×109/L비(160±61)×109/L],대조조치료후혈홍단백수평균명현고우치료전[(138±13) g/L비(133±13) g/L] (P ＜0.05).관찰조화대조조치료후간신공능지표무명현개변(P＞0.05).2조간치료전후심공능、생화지표화간신공능지표비교차이균무통계학의의(균P＞0.05).대조조화관찰조불량반응발생솔비교,차이무통계학의의(P＞0.05).수방6개월,대조조7례、관찰조6례심력쇠갈악화,차이무통계학의의(P＞0.05).결론 염산오보력농단기응용능유효완해심력쇠갈적림상증상,대간신공능무명현불량영향.
Objective To explore the effect and safety of olprinone in treating congestive heart failure (CHF).Methods Totally 52 patients of CHF from April 2009 to May 2010 were randomly divided into observation group (26 cases) receiving olprinone and control group (26 cases) receiving milrinone.Before and after treatment,the echocardiogram parameters [including left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV),left ventricular ejection fraction (LVEF),left ventricular fractional shortening (LVFS) and left atrial diameter] were measured; the cardiothoracic ratio on chest X-ray,liver and renal functions,blood and urine routine examinations,general states,heart function scores [New York heart association (NYHA) class and Boston score] and adverse reactions were recorded; the cadiovascular events (deterioration,readmission,death) 6 months after discharge were followed up.Results The effective rates showed no significantly differences between observation group and control group regarding NYHA class [88.5％ (23/26) vs 84.6％ (22/26)] and Boston score [61.5％ (16/26) vs 57.7％ (15/26)] (P ＞ 0.05).The heart rate,systolic blood pressure,Boston score,LVEF,LVEDV,LVESV and LVFS were all significantly improved after treatment in observation group [(73 ±10) times/min vs (94 ±26) times/min,(120±11) mmHg vs (128 ±19) mmHg,(5.4 ± 1.7) scorevs (9.9±1.3) score,(47±11)％ vs (41 ±11)％,(222±74) ml vs (236±75) ml,(118 ± 57) ml vs (138 ±67) ml,(27 ±8) mm vs (23 ±8) mm] and control group [(76 ± 11) times/min vs (100 ± 30) times/min,(119 ±10) mmHg vs (127 ±21) mmHg,(5.7 ± 1.6) score vs (9.8 ±1.0) score,(47 ± 19)％ vs (43±7)％,(218±67) ml vs (231 ±69) ml,(116±50) ml vs (133 ±55) ml,(25 ±5) mm vs (22 ± 4) mm] (P ＜ 0.05),but diastolic blood pressure,cardiothoracic ratio,LVEDD,LVSDD and left atrial diameter were not significantly improved (P ＞ 0.05).After treatment,the hemoglobin and blood platelet in observation group,the hemoglobin in control group were significantly increased[(141 ± 22) g/L vs (139 ± 19) g/L,(184±67) × 109/L vs (160 ±61) × 109/L,(138 ± 13) g/L vs (133 ± 13) g/L] (P＜0.05).No statistical changes of liver and kidney function were found after treatment in both groups (P ＞ 0.05).No significant differences of these parameters were found between the two groups (P ＞ 0.05).The incidence of adverse reactions was not significantly different between the two groups (P ＞ 0.05).During 6 months of follow-up period,deteriorations were observed in 7 patients in control group and 6 patients in observation group without statistical differences (P ＞ 0.05).Conclusion Short time-use of olprinone can effectively and safely relieve the clinical symptoms in patients of CHF,without influence on liver and kidney function.
