米力农治疗高龄老人慢性心衰的疗效及安全性观察(1)
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[摘要] 目的 观察小剂量短期使用米力农治疗高龄老人慢性心力衰竭急性加重期的疗效及安全性。 方法 将140例高龄慢性心力衰竭急性加重期心功能3～4级的住院患者随机分为A、B两组，各70例。A组(对照组)予常规抗心衰治疗，B组(治疗组)在A组常规治疗的基础上，加用小剂量短期米力农治疗(10 mg，泵滴5 h，5d为一疗程)。观察治疗前后患者临床症状、N末端脑钠肽前体水平、血压、心率、左心射血分数等的变化。B组患者治疗前后均行24小时动态心电图检查，采用自动分析以及人工确定分析。 结果 A组总有效率48.5%，B组总有效率82.9%，两组率间差异具有统计学意义(P<0.05)；B组患者经小剂量米力农治疗前后，室性心律失常总数无明显的变化(P>0.05)。 结论 小剂量短期使用米力农治疗高龄老人慢性心力衰竭急性加重期安全有效，治疗前后室性心律失常发生总数无明显的变化，值得进一步临床应用及探讨。
[关键词] 米力农；慢性心力衰竭急性加重期；心律失常；高龄
[中图分类号] R541.6+1 [文献标识码] B [文章编号] 1673-9701(2012)02-0060-03
Clinical effect and safely observation on milrinone in treatment of advanced age patients with chronic cardiac failure
CHEN Sui LUO Xuesheng WANG Shanshan LI Qi CHEN Lin HE Lu MENG Yanling
Department of Geriatrics Ward of PLA 113 Hospital, Ningbo 315040, China
[Abstract] Objective To observe the effect and safety on low-does and short-term use of milrinone in treatment of advanced age patients with acute exacerbation of chronic cardiac failure. Methods All of 100 cases of patient with acute exacerbation of chronic cardiac failure in advanced age patients (>80 years) were randomly divided into two groups，A and B. A (control group) received conventional therapy, and B (treatment group)received conventional treatment with the addition of milrinone 10 mg，continuous infusion 5 hours everyday，5 days for treatment. To observe the changes of cardiac function, nerval pro-brain natriuretic peptide level, blood pressure, heart rate, cardiac ultrasonography before and after treatment. Patients of B(treatment group) test with 24 hours hoter before and after treatment and the data were analyzed automatically and manually. Results The total effective rate was 82.9% in treatment group, significantly higher than that in contral group which was 48.5%.There was no obviously change of Arrhythmias before and after treatment in the treatment group. Conclusion It is safe and effective for low-doses and short-term using milrinon in treatment of advanced age patients with acute exacerbation of chronic cardiac failure ......
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