A Comparison Of Therapeutic Effect Of Olprinone Hydrochloride Injection And Milrinone In The Treatment In Congestive Heart Failure

Objective:Heart failure is a variety of organic heart disease terminal stage performance with high morbidity and high mortality.In recent years ,with the rapid development of basic research and clinical research in drug treatment in heart failure。there has been many new highlights. PDEIII inhibitors exert positive inotropic and vasodilatory effects by increasing intracellular cAMP .This study evaluated the efficiency and security of a new generated phosphodiesteraseⅢinhibitor through comparing olprinone with milrinone in heart failure .Methods:36 cases of heart failure patients were selected in random, those patients were treated in the people's hospital of Liaoning Province from April to October 2009. There are male 29 and female 7 aged from 32～75 years old , the average age is 58.40±9.06 years old . They are divided into two groups randomly . Treatment group are 18 cases , which were given Olprinone hydrochloride first to 10μg/kg injection amount, diluted in 20ml physiological saline slow intravenous injection (5-10 minutes). Then, the amount per minute 0.45μg/kg intravenous drip infusion, with physiological saline or glucose injection was diluted to 100ml, at the rate of 0.5ml per minute, or the rate of 7-8 continuous intravenous drip 3 hours, 5 days a course of treatment. Control group are 18 cases,which were given milrinone injection. Firstly, to 50μg/kg injection amount, diluted in 20ml physiological saline slow intravenous injection (5-10 minutes). Then, the amount per minute 0.65μg/kg intravenous drip infusion , with physiological saline or glucose injection was diluted to 100ml, at the rate of 0.5ml per minute, or the rate of 7-8 continuous intravenous drip 3 hours, 5 days a course of treatment . Before and after treatment, cardiac function was observed in patients with a heart ultrasonic level and determination of cardiac function index, the incidence of adverse reactions observed. The date were examined by chi-square test and t test .P<0.05 was considered statistic significance.Results:Before and after treatment, treatment group and control group have significant statistical differences. The scores of Boston in treatment group and control group after treatment and the change in cardiac function had significant differences than before treatment. In treatment group, the total effective rate was 72%, in the control group total effective rate was 61%, significant improvement in left ventricular systolic dysfunction. Two groups of left ventricular end diastolic diameter (LVEDD) and volume (LVEDV), end systolic diameter (LVSDD) and volume (LVESV), left ventricular ejection fraction (EF), fractional shortening (FS), left ventricular filling index (Peak E, Peak A, three-dimensional left atrial diameter) are obvious different in the before and after treatment, P <0.05 has statistics meanings. Abnormal liver function during treatment and thrombocytopenia side effects were found in treatment group, meanwhile hypotension, electrolyte imbalance, left atrial thrombus and ventricular arrhythmias suspected serious adverse reactions were found in the control group.Conclusion: Olprinone and milrinone are PDEⅢinhibitors,which can selectively inhibit the cardiac phosphodiesterase cells (PDEs), glycosides increase intracellular cyclic phosphate (cAMP), changes in the functioning of calcium ions inside and outside the cell membrane, enhances myocardial contractility, and play function of relaxing vascular smooth muscle directly. Clinical efficacy between the two was no significant difference, but the severity of adverse reactions of applying hydrochloride olprinone was lower than milrinone. Therefore, its security is higher.