我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

米力农治疗冠状动脉旁路移植术后左室功能障碍的短期疗效

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第5期
页码:
572-574,578
栏目:
临床研究
出版日期:
2014-05-25

文章信息/Info

Title:
Effect of milrinone on short-term outcome of patients with myocardial dysfunction undergoing coronary artery bypass graft
作者:
郭艳娟; 曹树军; 胡硕强; 王助衡
(北京市大兴区人民医院心内科，北京 102600)
Author(s):
GUO Yan-juan;  CAO Shu-jun;  HU Shuo-qiang;  WANG Zhu-heng
(Department of Cardiology, Beijing Daxing District People’s Hospital, Beijing 102600, China)
关键词:
米力农; 左室功能障碍; 冠状动脉旁路移植术; 心肌缺血; 心肌梗死
Keywords:
milrinone;  left ventricular dysfunction;  coronary artery bypass graft;  myocardial ischemia;  myocardial infarction
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
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(50 μg/kg)静脉注射并于术后24 h 0.5 μg/(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。
Abstract:
AIM:To evaluate the effect of milrinone on patients with ventricular dysfunction undergoing coronary artery bypass graft (CABG). METHODS: Sixty-two patients with impaired left ventricular function ［left ventricular ejection fraction (LVEF)<35%］ undergoing CABG were enrolled. Patients were randomized to receive either an intraoperative bolus of milrinone (50 μg/kg) or saline as placebo, followed by a 24-h infusion of each agent ［0.5 μg/(kg·min)］. Hemodynamic parameters and transthoracic echocardiographic measurement of systolic and diastolic functions were evaluated. RESULTS: Serum levels of creatine phosphokinase (CPK), MB isoenzyme of creatine kinase (CK-MB), occurrence of myocardial ischemia or infarction, and mean duration of using inotropic agents were significantly lower in the milrinone group (P<0.05, P<0.01). There were no significant differences between groups in the development of ventricular arrhythmia, intra-aortic balloon pump and inotropic support requirement, duration of mechanical ventilation and 24-h mortality rate. Although mean preoperative LVEF was significantly lower in milrinone group, there was no significant difference in postoperative LVEFs. CONCLUSION: We suggest perioperative administration of milrinone in patients undergoing CABG, especially in those with low LVEF.

参考文献/References

[1]Heringlake M,Wernerus M,Grunefeld J,et al.The metabolic and renal effects of adrenaline and milrinone in patients with myocardial dysfunction after coronary artery bypass grafting[J].Crit Care,2007,11(2):R51.
[2]Jeon Y,Ryu JH,Lim YJ,et al.Comparative hemodynamic effects of vasopressin and norepinephrine after milrinone-induced hypotension in off-pump coronary artery bypass surgical patients[J].Eur J Cardiothorac Surg,2006,29(6):952-956.
[3]靳中奎,王世杰,李俊杰.米力农和多巴胺在非体外循环下冠状动脉旁路移植术后心功能不全应用的临床对比[J].中国伤残医学,2013,4(1):44-45.
[4]祝 岩,王辉山,李新民,等.不同血管活性药物在冠状动脉旁路移植手术中的实验研究[J].临床误诊误治,2013,1(1):52-55.
[5]祝 岩,王辉山,李新民,等.米力农,酚苄明,硝酸甘油与维拉帕米混合液预防与治疗人桡动脉痉挛的实验研究[J].中国胸心血管外科临床杂志,2013,20(2):198-203.
[6]Kikura M,Levy JH,Michelsen LG,et al.The effect of mil-rinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass［J］. Anesth Analg,1997,85(1):16-22.
[7]于海英，焦金菊.磷酸二酯酶抑制剂对糖尿病大鼠抗氧化作用的实验研究[J].解放军医学院学报,2013,34(4):402-404.
[8]Sedlis SP,Ramanathan KB,Morrison DA,et al.Outcome of percutaneous coronary intervention versus coronary bypass grafting for patients with low left ventricular ejection fractions,unstable angina pectoris, and risk factors for adverse outcomes with bypass(the AWESOME Randomized Trial and Registry)[J].Am J Cardiol,2004,94(1):118-120.
[9]Wright EM,Sherry KM.Clinical and haemodynamic effects of milrinone in the treatment of low cardiac output after cardiac surgery[J].Br J anaesth,1991,67(5):585-590.
[10]Hein M,Roehl AB,Baumert JH,et al.Anti-ischemic effects of inotropic agents in experimental right ventricular infarction[J].Acta Anaesthesiol Scand,2009,53(7):941-948.
[11]Levy JH,Bailey JM,Deeb GM.Intravenous milrinone in cardiac surgery[J].Ann Thorac Surg,2002,73(1): 325-330.
[12]George M,Lehot JJ,Estanove S.Haemodynamic and biological effects of intravenous milrinone in patients with a low cardiac output syndrome following cardiac surgery: multicentre study[J].Eur J Anaesthesiol,1992,5(1):31-34.

备注/Memo

备注/Memo:
收稿日期：2013-12-22.
作者简介：郭艳娟，主治医师 Email：1276734626@qq.com
更新日期/Last Update: 2014-06-05