米力农雾化治疗小儿重症肺炎合并心力衰竭的疗效

doi:10.6040/j.issn.1671-7554.0.2015.730

摘要/Abstract

摘要： 目的探讨米力农雾化治疗新生儿及小婴儿重症肺炎合并心力衰竭的疗效及安全性。方法选择240例重症肺炎合并心力衰竭的患儿,随机分为对照组和观察组,每组120例。对照组给予常规洋地黄、利尿等基础治疗;观察组在对照组的基础上加用米力农雾化。观察两组临床疗效和心功能指标的变化。结果治疗5 d后,两组中大部分患者的临床症状、体征及心功能指标均改善,观察组治疗前后各项观察指标的改善均优于对照组,两组治疗后临床疗效和心功能指标差值比较,差异有统计学意义(P<0.05)。结论在常规洋地黄、利尿等治疗基础上,米力农雾化能更快地减低肺循环阻力、减少心脏前负荷和后负荷,从而有效地改善患儿心功能。

关键词: 重症肺炎, 心力衰竭, 米力农雾化, 肺动脉高压

Abstract: Objective To discuss the curative effect and security of milrinone atomization inhalation on treating severe pneumonia complicated with heart failure in noenates and infants. Methods A total of 240 cases with severe pneumonia complicated with heart failure in the fourth Peoples Hospital of Jinan City from 2012 to 2015 were randomly divided into control group and observation group, 120 in each group. The control group was treated with digitalis, diuretic, and other conventional therapies; on this basis, the observation group was treated additionally with milrinone atomization inhalation. Changes of the clinical efficacy and cardiac function indexes of the two groups were observed. Results After 5 days of treatment, clinical symptoms, signs and cardiac function indexes were improved significantly in the two groups. The improvement of cardiac function indexes in the observation group was better than that in the control group. The difference of clinical efficacy and cardiac function indexes before and after the treatment in the two groups were statistically significant(P<0.05). Conclusion On the basis of routine treatment such as digitalis and diuretic therapy, milrinone atomization inhalation can reduce the pulmonary circulation resistance, cardiac preload and afterload, thus effectively improve the heart function in noenates and infants with severe pneumonia complicated with heart failure.

Key words: Severe pneumonia, Pulmonary artery hypertension, Milrinone atomization, Heart failure

中图分类号:

R725.6

许天一,吴萍,王爱玲,陈丽萍. 米力农雾化治疗小儿重症肺炎合并心力衰竭的疗效[J]. 山东大学学报（医学版）, 2016, 54(7): 88-90.

XU Tianyi, WU Ping, WANG Ailing, CHEN Liping. Clinical effect of milrinone atomization inhalation on treating severe pneumonia complicated with heart failure of neonates and infants[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(7): 88-90.

参考文献

[1] 马登勋,王利东.米力农联合多巴胺治疗小儿肺炎合并心力衰竭[J]. 新乡医学院学报, 2012, 29(5):381-383. MA Dengxun, WANG Lidong. Milrinone combined with dopamine in the treatment in children with pneumonia complicated with heart failure[J]. Xinxiang Medical College Journal, 2012, 29(5):381-383.
[2] Kobayashi S, Susa T, Tanaka T, et al. Low-dose β-blocker in combination with milrinone safely improves cardiac function and eliminates pulsus alternans in patients with acute decompensated heart failure[J]. Circ J, 2012, 76(7):1646-1653.
[3] 胡亚美, 江载芳.诸福棠实用儿科学[M]. 7 版. 北京: 人民卫生出版社, 2002: 1511-1525.
[4] Hentschel T, Yin N, Riad A, eI al. Inhalation of the phosphodies-terase-3 inhibitor milrinone attenuates pulmonary hypertension in an experimental model of congestive heart failure[J]. Anesthesiology, 2007, 106(1):124-131.
[5] 王耀菊. 米力农治疗小儿充血性心力衰竭疗效观察[J]. 中国实用儿科杂志, 2010, 22(11): 91-92. WANG Yaoju. Milrinone in the treatment of children with congestive heart failure curative effect observation[J]. Chinese Journal of Practical Pediatrics, 2010, 22(11):91-92.
[6] 孔令先. 米力农治疗顽固性心力衰竭的临床疗效及安全性分析[J]. 中国保健营养, 2013, 6(1):201-202. KONG Lingxian. Milrinone in treatment of refractory heart failure clinical efficacy and safety analysis[J]. China Health Nutrition, 2013, 6(1):201-202.
[7] Rieg AD, Suleiman S, Perez-Bouza A, et al. Milrinone relaxes plumonary veins in guinea pigs and humans[J]. PLoS One, 2014, 9(1):e876-885. doi: 10.1371/journal.pone.0087685.
[8] 冯永萌, 郭瑞霞, 张菲菲. 不同剂量米力农在充血性心力衰竭治疗中的疗效及安全性[J]. 中国医药指南, 2013, 11(3): 152-153. FENG Yongmeng, GUO Ruixia, ZHANG Feifei. Different dose of milrinone in the treatment of congestive heart failure efficacy and safety [J]. Guide to Chinese Medicine, 2013, 11(3):152-153.
[9] Birger A, Mikael A, Anders M, et al. Milrinone improves dias-tolic function in coronary artery bypass surgery as assessed by acoustic quantification and peak filling rate: a prospective randomized study[J]. J Cardiothorac Vasc Anesth, 2010, 24(2):244-249.
[10] Lee J, Kim GB, Kwon HW, et al. Safety and efficacy of the off-label use of milrinone in pediatric with heart desases[J] Korean Circ J, 2014, 44(5):320-327.
[11] Mc Namara PJ, Laique F, Muang-In S, et al. Milrinone improves oxygenation in neonates with severe persistent pulmonary hypertension of the newborn[J]. J Crit Care, 2006, 21(2):217-222.
[12] Lakshminrusimha S, Porta NF, Farrow KN, et al. Milrinone enhances relaxation to prostacyclin and iloprost in pulmonary arteries isolated from lambs with persistent pulmonary hypertension of the newborn[J]. Pediatr Crit Care Med, 2009, 10(1):106-112.
[13] Faraday N. Perioperative platelet activation and the inhibitory effect of milrinone[J]. Anesthesiology, 2009, 111(6):1185-1186.
[14] Lamarche Y, Malo O, Thorin E, et al. Inhalde but not ineravenous milrinong prevents pulmonary endothelial dysfunction after cardiopulmonary bypass[J]. J Thorac Cardiovasc Surg, 2005, 130(1):83-92.

相关文章 15

[1]	张栾,陈欧,栾云,朱晓波,陈元,王一彪. Gemigliptin对野百合碱诱导的肺动脉高压大鼠治疗作用及炎症因子的影响[J]. 山东大学学报（医学版）, 2017, 55(5): 19-22.
[2]	姜蕴珊,谈红,李晓燕,苏莉,张国明,张红明,孟楠. 培哚普利对慢性心力衰竭患者血浆miR-423-5p的调控及对心功能的影响[J]. 山东大学学报（医学版）, 2016, 54(8): 55-59.
[3]	潘艳艳,孙永超,赵翠芬,孔清玉. 波生坦治疗婴儿先心病合并肺动脉高压的临床观察[J]. 山东大学学报（医学版）, 2016, 54(2): 53-56.
[4]	刘慧敏, 刘邓, 李晓宇, 邹淑奉, 姜黎民, 李玉环. 半边莲生物碱对肺动脉高压大鼠ET-1信号通路的影响[J]. 山东大学学报（医学版）, 2015, 53(8): 1-4.
[5]	唐蒙蒙, 金女娃, 刘传振, 刘凯, 曹广庆, 王鹤, 庞昕焱, 吴树明. 丙酮酸乙酯对高动力性肺高压的治疗作用[J]. 山东大学学报（医学版）, 2015, 53(5): 75-80.
[6]	刘霄岩. 米力农治疗难治性心力衰竭80例临床观察[J]. 山东大学学报（医学版）, 2014, 52(S2): 61-61.
[7]	尹黎波, 李慧萍. 曲美他嗪治疗重症疾患并发慢性心力衰竭患者的临床疗效[J]. 山东大学学报（医学版）, 2014, 52(S2): 99-100.
[8]	周长学. 多巴酚丁胺联合参附注射液治疗扩张型心肌病重度心力衰竭(附典型病例1例)[J]. 山东大学学报（医学版）, 2014, 52(S1): 132-133.
[9]	姜红梅1，2，陈文强1. 老年冠心病心衰患者运动康复治疗中心理干预的临床意义[J]. 山东大学学报（医学版）, 2014, 52(4): 85-88.
[10]	王亚云1, 王一彪1, 张雪1, 林梅1, 苏宏1，马宇1，朱晓波1, 陈欧2. PS-341对肺动脉高压大鼠Nrf2/NF-κB表达的影响及作用机制[J]. 山东大学学报（医学版）, 2014, 52(2): 6-11.
[11]	刘善文1，王福1, 李彬2，耿海华3，李彩娥4，许哲5，李睿1，肖洁1，张森1，季晓平1. 大鼠骨髓间充质干细胞exosome提取及其心肌细胞H9C2靶向作用的实验探索[J]. 山东大学学报(医学版), 2013, 51(9): 1-7.
[12]	孟庆红1，赵翠芬1，孔清玉1，李福海1，李栋2，夏伟1. 尾加压素Ⅱ对大鼠肺动脉平滑肌细胞胶原合成的影响[J]. 山东大学学报(医学版), 2013, 51(5): 15-19.
[13]	薛明华1，张琴2，侯代伦1，徐庆国2，隋树建3. 组织多普勒成像对肺动脉高压患者右心功能的评价[J]. 山东大学学报(医学版), 2013, 51(4): 37-41.
[14]	谷颖，王爱红，屈福超，陈东昌，张克，鹿克风. HO-1对AngⅡ诱导的乳鼠心肌细胞凋亡的作用[J]. 山东大学学报(医学版), 2013, 51(06): 1-4.
[15]	吴文振1, 郝恩魁1,程义伟1，解崔环2,孟彦3,苏国海1. 不同急性肺动脉高压模型的建立及其血流动力学转归的实验研究[J]. 山东大学学报(医学版), 2012, 50(3): 34-39.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed