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目的 :比较米力农与氨茶碱对慢性肺心病急性发作期降低肺动脉压的疗效以及对心率的影响。方法 :6 9例慢性肺心病急性发作期病人 ,随机分为 2组 ,米力农组 37例 ,男性 2 2例 ,女性 15例 ,年龄 (54±s10 )a ;氨茶碱组 32例 ,男性 2 1例 ,女性11例 ,年龄 (57± 5)a。用右心飘浮导管检测 2组用药前的肺动脉压。米力农组以米力农 50 μg·kg- 1加入 5%葡萄糖注射液 10mL ,静脉推注 ;氨茶碱组以 0 .2 5g氨茶碱加入 50 %葡萄糖注射液 4 0mL ,静脉推注。立即测定 2组用药后的肺动脉压 ,并观察2组用药前后的心率变化。结果 :2组用药后肺动脉压即刻均有显著降低 ,P <0 .0 5。米力农组显效率4 3% ,有效率 4 6 % ,总有效率 89% ;氨茶碱组分别为4 1% ,50 %及 91% ,组间比较无差异 ,P >0 .0 5。用药后米力农组心率无显著变化 ,而氨茶碱组心率明显增加 ,P <0 .0 1。结论 :静脉注射米力农与氨茶碱都能较好地即刻降低慢性肺心病急性发作期的肺动脉压 ,但静注氨茶碱有心率增快 ,甚至可能引起快速型心律失常的不良反应。
Objective: To compare the efficacy of milrinone and aminophylline in reducing pulmonary arterial pressure during acute attack of chronic pulmonary heart disease and its effect on heart rate. Methods: Sixty-nine patients with acute episode of chronic pulmonary heart disease were randomly divided into two groups. There were 37 cases in Milian group, including 22 males and 15 females, with a mean age of (54 ± 10 s) There were 21 males and 11 females, with a mean age of 57 ± 5 years. Right heart floating catheter test two groups of pulmonary artery pressure before treatment. Milrinone with milrinone 50 μg · kg-1 added 5% glucose injection 10mL, intravenous injection; aminophylline group 0.25g aminophylline 50% glucose injection 40mL, intravenous injection . Pulmonary arterial pressure immediately after the two groups were measured, and heart rate changes before and after treatment were observed. Results: Pulmonary arterial pressure was significantly reduced immediately after treatment in both groups (P <0.05). The effective rate was 41.3%, the effective rate was 46% and the total effective rate was 89% in the Milrinone group, 41%, 50% and 91% in the aminophylline group, respectively. There was no significant difference between the two groups (P> 0.05) . There was no significant change in heart rate of milrinone group after treatment, but the heart rate of aminophylline group increased significantly (P <0.01). Conclusion: Both intravenous injection of milrinone and aminophylline can reduce pulmonary arterial pressure immediately after acute episodes of chronic pulmonary heart disease. However, intravenous injection of aminophylline increases heart rate and may even cause adverse reactions of tachyarrhythmia.