米力农对copd引起慢性肺源性心脏病合并右心衰-安徽医药杂志社.docVIP

米力农对COPD引起慢性肺源性心脏病合并右心衰临床疗效分析 周平( 孙洪岩 【摘要】目的 探讨米力农治疗COPD引起慢性肺源性心脏病合并右心衰的临床疗效。方法 选择COPD引起慢性肺源性心脏病合并右心衰竭患者45例，治疗组25例，对照组20例。两组均给予常规综合治疗，治疗组加用米力农微泵静脉持续泵入治疗，观察患者心率、动脉血气PaO2、PaCO2、BNP变化；及心脏彩超左室射血分数（LVEF）、肺动脉压（PAP）、右室内径、三尖瓣反流变化。结果 两组患者治疗后心率、BNP较治疗前均明显下降（P0.001），治疗组BNP下降更明显，低于对照组水平（P0.05）。两组患者治疗后LVEF均有改善，PAP、右室内径较治疗前有下降（P0.001），治疗组与对照组间比较，差异无统计学差意义（P0.05）。中度肺动脉高压患者治疗后BNP明显下降，LVEF升高，右室内径减小（P0.05），重度肺动脉高压患者治疗后BNP明显下降，右室内径减小（P0.05），LVEF有改善，但差异无统计学意义（P0.05）。结论 短期使用米力农治疗COPD引起慢性肺源性心脏病合并右心衰能够有效缓解右心衰的临床症状，降低心率、BNP、PAP及右室内经。 【关键词】慢性肺源性心脏病；右心衰；米力农 The clinical analysis of milrinone for chronic obstructive pulmonary disease caused chronic pulmonary heart disease complicating heart failure ZHOU Ping, SUN Hongyan.Department of Respiratory,Anhui No.2 Province People’s Hospital,Hefei 230041,China [Abstract] Objective To investigate the clinical effect of milrinone for chronic obstructive pulmonary disease caused chronic pulmonary heart disease complicating heart failure.Method 45 patients with chronic pulmonary heart disease complicating heart failure caused by chronic obstructive pulmonary disease were selected, 25 cases in treatment group and 20 cases in control group.Two groups of patients were treated with comprehensive therapy, the treatment group was treated with milrinone on the basis of comprehensive therapy. Observed the patient’s heart rate, arterial blood PaO2, PaCO2,B-type natriuretic peptide(BNP)changes; and left ventricular ejection fraction (LVEF), pulmonary artery pressure (PAP), right ventricular inside diameter, three tip valve regurgitation changes.Result The patient’s heart rate, BNP were significantly decreased after treatment than before in two groups (P0.001), the treatment group BNP decreased more significantly, lower than the control (P0.05). After treatment the LVEF were improved, PAP and right ventricular diameter were decreased than before(P0.001), however between the two groups the difference was not statistically significant (P0.05). BNP and the right ven