鲁桓+麦鲁旦·麦麦提吐尔逊+郑伊颖+阮敏+袁祥+黄德华

【摘要】 目的 研究米力农对扩张型心肌病顽固性心力衰竭（心衰）患者心功能及血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平的影响。方法 80例扩张型心肌病顽固性心衰患者， 随机分为观察组与对照组， 每组40例。所有患者均采用常规抗心衰治疗， 观察组在此基础上加以米力农治疗。分别测定两组患者心功能及血清TNF-α、IL-6水平， 并记录两组治疗后不良反应发生情况。结果 治疗后两组TNF-α、IL-6水平均较治疗前显著降低， 差异具有统计学意义（P<0.05）， 且观察组明显低于对照组， 差异具有统计学意义（P<0.05）。治疗后两组心输出量（CO）、心脏每搏量（SV）、左室射血分数（LVEF）均优于治疗前， 差异具有统计学意义（P<0.05）， 且观察组明显优于对照组， 差异具有统计学意义（P<0.05）。观察组不良反应发生率为22.50%， 与对照组20.00%比较差异无统计学意义（P>0.05）。结论 米力农用以治疗扩张型心肌病顽固性心衰可明显改善患者心功能及血清TNF-α、IL-6水平， 对改善患者预后具有积极意义。

【关键词】 米力农；扩张型心肌病；顽固性心力衰竭；心功能；肿瘤坏死因子-α；白细胞介素-6

DOI：10.14163/j.cnki.11-5547/r.2016.36.009

【Abstract】 Objective To study influence of milrinone on cardiac function and serum tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） level for dilated cardiomyopathy patients with refractory heart failure. Methods A total of 80 dilated cardiomyopathy patients with refractory heart failure were randomly divided into observation group and control group， with 40 cases in each group. All patients received conventional anti heart failure treatment， and the observation group also received milrinone for treatment. Detection were made on cardiac function and serum TNF-α， IL-6 level in two groups， to record adverse reactions after treatment in two groups. Results Both groups had lower TNF-α， IL-6 level after treatment than before treatment， and their differences had statistical significance （P<0.05）. The observation group had lower indexes than the control group， and the differences had statistical significance （P<0.05）. Both groups had better cardiac output （CO）， stroke volume （SV） and left ventricular ejection fraction （LVEF） than before treatment， and their difference had statistical significance （P<0.05）. The observation group had better indexes than the control group， and the difference had statistical significance （P<0.05）. The observation group had adverse reaction rate as 22.50%， which was 20.00% in the control group， and the difference had no statistically significant difference （P>0.05）. Conclusion Implement of milrinone for the treatment of dilated cardiomyopathy patients with refractory heart failure can clearly improve cardiac function and serum TNF-α and IL-6 level. It also shows positive effect for improvement of prognosis in patients.

【Key words】 Milrinone； Dilated cardiomyopathy； Refractory heart failure； Cardiac function； Tumor necrosis factor-α； Interleukin-6

慢性心力衰竭是一種常见的临床综合征， 扩张型心肌病主要以左心室或双心室扩大伴收缩功能障碍为特征的心肌病[1]。患者随着病情进行性发展， 晚期出现显著的心脏扩大， LVEF也发生明显下降， 表现为顽固性终末期心力衰竭[2]。本病的患者处于心脏衰竭的终末期， 治疗应该针对改善患者的心衰症状， 延缓心衰病情的进程， 提高预后。研究发现米力农能在短期内明显缓解患者症状及其心功能[3-7]。本文研究米力农对扩张型心肌病顽固性心衰患者心功能及血清TNF-α、IL-6水平的影响， 现报告如下。

1 资料与方法

1. 1 一般资料 选取2015年5月～2016年4月共80例扩张型心肌病顽固性心衰患者， 按随机数字表法分为观察组与对照组， 每组40例。……