米力农与洋地黄毒苷片治疗慢性心力衰竭的疗效及对心功能的影响

严新美 万红梅 夏金兰 王菁 曾庆宏

摘 要 目的：探讨米力农与洋地黄毒苷片治疗慢性心力衰竭的疗效及对心功能的影响。方法：收集2015年1月—2018年8月收治的慢性心力衰竭患者82例，按照不同用药方案分为观察组35例和对照组47例。对照组给予对症治疗和洋地黄毒苷片，每日0.125 mg/次或0.25 mg/次，共2周。观察组在对照组基础上每日静脉泵注含米力农0.3 mg/kg的氯化钠液50 ml，共2周。观察两组患者的疗效和治疗前后Lee氏计分、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）和心脏指数（CI）变化情况。结果：观察组总有效率为94.29%（33/35），优于对照组的76.60%（36/47，P<0.05）。观察组治疗后Lee氏计分和LVEDD均低于对照组，LVEF和CI均高于对照组（P<0.05）。结论：米力农联合洋地黄毒苷片治疗慢性心力衰竭疗效显著，可明显改善患者心功能，可作为优选治疗方案。

关键词 慢性心力衰竭；米力农；洋地黄毒苷片；心功能

中图分类号：R541.6 文献标志码：A 文章编号：1006-1533（2020）02-0021-02

Therapeutic effect of milrinone and digoxigenin tablets in the treatment of chronic heart failure and its influence on cardiac function

YAN Xinmei， WAN Hongmei， XIA Jinlan， WANG Jing， ZENG Qinghong

（Internal Medicine-Cardiovascular Department of Peoples Hospital of Xinyu， Jiangxi 338000， China）

ABSTRACT Objective： To investigate the therapeutic effect of milrinone and digitalis tablets in the treatment of chronic heart failure and its effect on cardiac function. Methods： From January 2015 to August 2018， 82 patients with chronic heart failure were collected and divided into an observation group with 35 cases and a control group with 47 cases according to different medication regimens. The control group was given symptomatic treatment and digitalis glycoside tablets， 0.125 mg/time or 0.25 mg/time daily for 2 weeks. On the basis of the control group， the observation group was intravenously injected 50 ml of sodium chloride solution containing milrinone 0.3 mg/kg daily for 2 weeks. The effects of the two groups and the changes of Lees score， left ventricular ejection fraction（LVEF）， left ventricular end-diastolic dimension（LVEDD） and cardiac index（CI） before and after treatment were observed. Results： The total effective rate in the observation group was 94.29%（33/35）， which was better than 76.60%（36/47） in the control group（P<0.05）. After treatment， Lees score and LVEDD in the observation group were lower than those in the control group， and LVEF and CI were higher in the observation group than those in the control group（P<0.05）. Conclusion： Milrinone combined with digitalis glycoside tablets has a significant effect in the treatment of chronic heart failure， and can significantly improve the heart function of patients， which can be used as the optimal treatment.

KEY WORDS chronic heart failure； milrinone； digitoxin tablet； cardiac function

慢性心力衰竭（心衰）是臨床常见的心血管病的终末表现，恶性程度较高，若不能及时控制病情容易导致死亡[1]。洋地黄毒苷片是一种具有刺激心肌兴奋、增强心肌收缩力的抗心衰常用药物，在改善血流动力学指标和迷走神经张力方面效果显著，但仍有部分患者效果欠佳[2]。米力农为具有扩张血管和增强心肌收缩力作用的磷酸二酯酶抑制剂[3]。本文报道洋地黄毒苷片联合米力农治疗心衰的临床效果。