米力农联合机械通气治疗老年急性心力衰竭的临床效果分析

Effects of milrinone combined with mechanical ventilation on serum cystatin C and B-type natriuretic peptide in elderly patients with acute heart failure

摘要:

目的 探讨米力农联合机械通气治疗老年急性心力衰竭患者的临床效果，及其对血清半胱氨酸蛋白酶抑制剂C（CysC）和脑钠肽（BNP）的影响。方法 选取2015年9月—2019年9月永康市第一人民医院收治的老年急性心力衰竭患者62例，采用随机数字表法分为观察组和对照组，每组31例。对照组采用机械通气治疗，观察组在机械通气治疗基础上联合米力农治疗。两组疗程均为1周。比较两组疗效，治疗前后血气分析指标、心功能指标、血清CysC和BNP的变化。结果 观察组总有效率（93.55%）高于对照组（74.19%）（P <0.05）。观察组治疗前后血氧分压和二氧化碳分压的差值大于对照组（P <0.05）。观察组治疗前后左心室舒张末期内径、左室射血分数和每博输出量的差值大于对照组（P <0.05）。观察组治疗前后血清CysC和BNP的差值大于对照组（P <0.05）。结论 米力农联合机械通气治疗老年急性心力衰竭患者效果明显，可明显降低血清CysC和BNP水平，改善患者血氧及心功能。

Abstract:

Objective To investigate the effects of milrinone combined with mechanical ventilation on serum cystatin C (CysC) and B-type natriuretic peptide (BNP) in elderly patients with acute heart failure.Methods Sixty-two elderly patients with acute heart failure in Yongkang First People's Hospital from September 2015 to September 2019 were divided into observation group (31 cases) and control group (31 cases) according to random number table method. The control group was treated with mechanical ventilation, while the observation group was treated with milrinone on the basis of mechanical ventilation. The course of treatment was 1 week in both groups. Blood gas analysis, cardiac function, serum CysC and BNP levels were compared between the two groups before and after treatment.Results The overall effective rate of the observation group (93.55%) was higher than that of the control group (74.19%) (P < 0.05). The differences of arterial partial pressure of oxygen (PaO₂) and carbon dioxide (PaCO₂) before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of left ventricular end-diastolic dimension (LVDd), left ventricular ejection fraction (LVEF) and stroke volume (SV) before and after treatment in the observation group were higher compared with control group (P < 0.05). Besides, the differences of serum CysC and BNP levels before and after treatment in the observation group were higher than those in the control group (P < 0.05).Conclusions Milrinone combined with mechanical ventilation has an obvious curative effect on elderly patients with acute heart failure, which can significantly decrease the levels of CysC and BNP, improve indicators for blood gas analysis and enhance cardiac function.