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目的观察米力农治疗慢性心力衰竭的临床疗效,并探讨其对心功能、肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法选取2012年1月—2015年5月广州医学院荔湾医院收治的慢性心力衰竭患者184例,采用随机数字表法分为对照组和观察组,每组92例。两组患者入院后均接受对症治疗,观察组患者在对症治疗基础上加用米力农。比较两组患者临床疗效,治疗前后心功能指标[包括左心室射血分数(LVEF)、心排出量(CO)、每搏输出量(SV)、舒张早期充盈峰最大充盈速度/舒张晚期充盈峰最大峰值速度(E/A比值)]及RAAS相关指标[包括血管紧张素Ⅱ(Ang-Ⅱ)、肾素活性(PRA)、醛固酮(ALD)],心力衰竭衰症状改善时间,住院时间,住院费用,治疗后1年内复发率及病死率。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者LVEF、CO、SV、E/A比值比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEF、CO、SV高于对照组,E/A比值低于对照组(P<0.05)。治疗前两组患者Ang-Ⅱ、PRA、ALD比较,差异无统计学意义(P>0.05);治疗后观察组患者Ang-Ⅱ、PRA、ALD低于对照组(P<0.05)。观察组患者心力衰竭症状改善时间、住院时间短于对照组,住院费用少于对照组,治疗后1年内复发率、病死率低于对照组,差异有统计学意义(P<0.05)。结论米力农治疗慢性心力衰竭的临床疗效确切,可有效改善患者心功能,抑制RAAS。
Objective To observe the clinical efficacy of milrinone in the treatment of chronic heart failure (CHF) and to explore its effect on cardiac function, renin-angiotensin-aldosterone system (RAAS). Methods From January 2012 to May 2015, 184 cases of chronic heart failure admitted to Liwan Hospital of Guangzhou Medical College were divided into control group and observation group with 92 cases in each group. Two groups of patients were admitted to symptomatic treatment after admission, the observation group patients on the basis of symptomatic treatment with milrinone. The clinical curative effect was compared between the two groups before and after treatment, including the left ventricular ejection fraction (LVEF), cardiac output (CO), stroke volume (SV), the maximum filling velocity of filling peak in early diastole / filling peak of late diastole Maximum peak velocity (E / A ratio)] and RAAS related indicators [including angiotensin II (Ang-Ⅱ), renin activity (PRA), aldosterone (ALD)], heart failure failure to improve the time, length of stay, hospitalization Costs, relapse rate and mortality within 1 year after treatment. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). There was no significant difference in LVEF, CO, SV, E / A ratio between the two groups before treatment (P> 0.05). After treatment, the LVEF, CO and SV in the observation group were higher than those in the control group, and the E / A ratio was lower than the control group Group (P <0.05). There was no significant difference in Ang-Ⅱ, PRA and ALD between the two groups before treatment (P> 0.05). After treatment, Ang-Ⅱ, PRA and ALD in observation group were lower than those in control group (P <0.05). Observation group patients with heart failure symptoms improved time, hospital stay shorter than the control group, hospitalization costs less than the control group, the recurrence rate within 1 year after treatment, mortality was lower than the control group, the difference was statistically significant (P <0.05). Conclusion Milrinone treatment of chronic heart failure clinical curative effect is exact, can effectively improve the patient’s cardiac function, inhibit RAAS.