氨力农治疗慢性肺心病难治性心衰30例疗效观察_0.docVIP

氨力农治疗慢性肺心病难治性心衰30例疗效观察 【关键词】 氨力农；肺心病；充血性心力衰竭 ［摘要］ 目的 研究 氨力农对慢性肺心病并难治性充血性心力衰竭的 治疗 效果及安全性。 方法 60例慢性肺心病并难治性心衰的患者被随机分为两组：氨力农组30例，在常规治疗的基础上每日加用氨力农100 mg；对照组30例，在常规治疗的基础上每日加用酚妥拉明10 mg，疗程5天。观察治疗前后心功能及血气 分析 的改善情况，心脏超声检测肺动脉压力和左室射血分数，肺功能仪测定第一秒用力肺活量，并记录临床不良反应。 结果 两组都有确切疗效，但与对照组比较，氨力农组心功能、肺功能、血气分析结果的改善更加显著，肺动脉压力的下降更为明显，差异具有显著性（P＜0.05）。氨力农组与对照组不良反应的发生率分别为0和10%。结论 氨力农治疗慢性肺心病并难治性心衰是安全有效的药物。 ［关键词］ 氨力农；肺心病；充血性心力衰竭 Clinical effect of amrinone on 30 patients with uncompensated chronic cor pulmonale ［Abstract］ Objective To study the clinical effect and safety of amrinone on patients of chronic cor pulmonale with obstinate congestive heart failure.Methods Sixty patients with obstinate congestive heart failure of chronic cor pulmonale were randomly divided into two groups.For the basic routine treatment,the 30 patients were administered 100 mg amrinone each day for 5 days,while the other 30 patients of the control were given 10 mg phentolamine for 5 days.We observed the changes of cardiac function,pulmonary artery pressure（PAP）,left ventricular ejection fraction（LVEF）,blood gas analysis and FEVI in both groups before and after the treatment.Adverse reactions were also recorded.Results Compared with patients of the control group,patients in the treatment group had a better improvement in cardiac function,pulmonary function and blood gas analysis,as well as a more marked decline in PAP.All these mearements had obvious difference in two groups. The frequency of adverse reactions was 0 and 10%,respectively in the amrinone group and the control group. Conclusion Amrinone is effective and safe for the treatment of uncompensated chronic cor pulmonale. ［Key words］ amrinone;cor pulmonale;congestive heart failure 慢性肺心病合并心衰时，由于缺氧及感染，对洋地黄类药物的耐受性很低，容易发生洋地黄中毒甚至猝死，笔者在临床实践中，采用氨力农治疗慢性肺源性心脏病合并难治性心衰取得了较好的疗效，现报告如下。 1 资料与方法 1.1 一般资料 所有符合诊断标准的60例入选病例随机分为两组，治疗组和对照组。治疗组30例，男19例，女11例，平均年龄（66±15.5）岁，平均病程（17.3±12.4）年，合并Ⅱ型呼衰20例，心功能级17例，级13例；对照组30例，男18例，女12例，平均年龄（68±17.8）岁，平均病程（15.9±13.8）年，合并型呼衰18例，心功能级