论文部分内容阅读
目的:评价米力农对冠状动脉搭桥术(CABG)中左室功能障碍患者短期疗效。方法:62例CABG术后低心排患者(左心室射血分数<35%)纳入该研究。将患者随机分为米力农组[n=31,米力农(50μg/kg)静脉注射并于术后24 h 0.5μg/(kg·min)持续泵入]和对照组(n=31,生理盐水作为安慰剂)。左室功能障碍采用血流动力学参数和经胸廓的超声心动图进行评估。结果:两组患者的基线水平有差异,术前米力农组患者的左心室射血分数低于对照组,术后两组无明显差异。米力农组的血清肌酸磷酸激酶(CK)及其同工酶(CK-MB)、发生心肌缺血或梗死和应用正性肌力药物的时间均显著低于对照组(P<0.05,P<0.01)。室性心律失常、使用主动脉内球囊反博的时间、机械通气和24 h病死率两组无明显差异。结论:对于接受CABG,尤其是左室射血分数较低的的患者,应用米力农可以减少心肌梗死发生的风险和应用正性肌力药物支持的时间。
Objective: To evaluate the short-term effect of Milrinone on left ventricular dysfunction in patients undergoing coronary artery bypass grafting (CABG). Methods: Sixty-two patients with low cardiac output after CABG (left ventricular ejection fraction <35%) were included in the study. The patients were randomly divided into Milrinone group (n = 31, Milrinone (50μg / kg) intravenously and pumped at 0.5μg / (kg · min) 24 hours after operation) and control group (n = 31, Saline as a placebo). Left ventricular dysfunction was assessed using hemodynamic parameters and transthoracic echocardiography. Results: There was a significant difference in baseline levels between the two groups. Preoperative left ventricular ejection fraction in the Milian group was lower than that in the control group, with no significant difference between the two groups. Milrinone serum creatine phosphokinase (CK) and its isoenzyme (CK-MB), myocardial ischemia or infarction and the application of inotropic drugs time were significantly lower than the control group (P <0.05, P <0.01). Ventricular arrhythmia, the use of intra-aortic balloon anti-Bo time, mechanical ventilation and 24 h mortality was no significant difference between the two groups. CONCLUSIONS: Milrinone may reduce the risk of myocardial infarction and the timing of inotropic support in patients receiving CABG, especially those with low LV ejection fraction.