米力農與洋地黃毒苷片治療慢性心力衰竭的療效及對心功能的影響

嚴新美 萬紅梅 夏金蘭 王菁 曾慶宏

摘 要 目的：探討米力農與洋地黃毒苷片治療慢性心力衰竭的療效及對心功能的影響。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，按照不同用藥方案分為觀察組35例和對照組47例。對照組給予對癥治療和洋地黃毒苷片，每日0.125 mg/次或0.25 mg/次，共2周。觀察組在對照組基礎上每日靜脈泵注含米力農0.3 mg/kg的氯化鈉液50 ml，共2周。觀察兩組患者的療效和治療前后Lee氏計分、左心室射血分數（LVEF）、左心室舒張末期內徑（LVEDD）和心臟指數（CI）變化情況。結果：觀察組總有效率為94.29%（33/35），優于對照組的76.60%（36/47，P<0.05）。觀察組治療后Lee氏計分和LVEDD均低于對照組，LVEF和CI均高于對照組（P<0.05）。結論：米力農聯合洋地黃毒苷片治療慢性心力衰竭療效顯著，可明顯改善患者心功能，可作為優選治療方案。

關鍵詞 慢性心力衰竭；米力農；洋地黃毒苷片；心功能

中圖分類號：R541.6 文獻標志碼：A 文章編號：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）是臨床常見的心血管病的終末表現，惡性程度較高，若不能及時控制病情容易導致死亡[1]。洋地黃毒苷片是一種具有刺激心肌興奮、增強心肌收縮力的抗心衰常用藥物，在改善血流動力學指標和迷走神經張力方面效果顯著，但仍有部分患者效果欠佳[2]。米力農為具有擴張血管和增強心肌收縮力作用的磷酸二酯酶抑制劑[3]。本文報道洋地黃毒苷片聯合米力農治療心衰的臨床效果。