A Clinical Study On The Eftectivity And Safety Of Ofprinone In Patients With Congestive Heart Failure

Cadiovascular diease is one of the diseases that impair the human healthmost, and heart failure is almost the end stage of them. Recently, with anincreasing morbidity of cardiovascular disease and the aging tendency ofpopulation, the morbidity of heart failure is going up year by year. The numberof adults suffered from heart failure has reached10million globally, and it hasbecoming one of the most common reasons for admission for the groups above65years old. It is a disease with a high morbidity, disability rate and mortality,and is certainly a terrible killer for the old. Inotropic agents are the mostcommon medicaments in treating heart failure, mainly including: cardiacglycoside, sympathomimetic amines and phosphodiesterase inhibitors.Olprinone is one of the new phosphodiesterase inhibitors following Amrinoneand Milrinone. It was initially developed by Eisai Pharmaceutical company,and came into the market in Japan in1996. Foreign clinical practice has provedthe effciency and safty of the use Olprinone in acute heart failure, but nosimilar study has began in China so far and the results of the study willcertainly offer a clinical guide for its future use in China.Subjects: Use Milrinone as the contrast group to evaluate the efficiencyand safty of the use of Olprinone in treating congestive heart failure.Methods: Use a randomized, single-blind, positive medicine, parallelcomparison test method.92patients who met the criteria were included in thestudy, and42patients for each group. Olprinone was used in the testing group,the load capacity was10μg/㎏, diluted to20ml, and was injected intravenouslyin10mintues. The maintenance dose was0.25μg/(kg·min), diluted to100ml,and was driping intravenously in3hours constantly, once a day; The controllgroup used Milrinone, the load capacity was50μg/㎏, diluted to20ml, and was injected intravenously in10mintues. The maintenance dose was0.65μg/(kg·min), diluted to100ml, and was driping intravenously in3hoursconstantly, once a day; both of the course of the treatment were5days. signs,symotoms, echocardiography, electrocardiogram, chest radiograph andbiochemical indicators were collected from the two groups before and after thetreatments, including the adverse reactions through out the treatment. All thedata were statistically analyzed finally.Results: Use NYHA cardiac function standard to evaluate the Efficency,the total effective rate is95.45%in the testing group and88.89%in the controllgroup. According to Boston Score evaluation, the total effective rate is79.54%in the testing group and73.33%in the controll group, Comparison in the groupwere statistically significant(P<0.01), Comparison between the two groupswere not statistically significant(P>0.05); LVEF in the testing group before andafter therapy is （32.65土10.38；37.91土10.93）%, and is（35.93土11.93；40.79土11.93）%in the control group, Comparison in the group werestatistically significant(P<0.01), Comparison between the two groups were notstatistically significant(P>0.05); Mitral valve reverse flow area, Aortic valvereverse flow area, Tricuspid reverse flow area, Pulmonary valve reverse flowarea were decreased in both groups, and Comparison in the group werestatistically significant(P<0.01), but Comparison between the two groups werenot statistically significant(P>0.05). Cr level is （92.09土27.98;84.19土25.22）μmol/L before and after the therapy in the testing group, and thecomparison is statistically significant(P<0.01). Cr level is （92.09土27.98;84.19土25.22）μmol/L before and after the therapy in the control group, andthe comparison is not statistically significant(P>0.05). There is no significantdifferences in liver and kidney function, urine and blood routine, bloodelectrolytes (P>0.05). The patients confronted with adverse effects in thetesting goup is8, and is7in the controll group, Comparison between the groups were not statistically significant (P>0.05).Conclusion:For the patients with congestive heart failure who had resisted standardtreatments, a short-term use of Olprinone will improve their clinical symptoms,signs and heart function, while with no serious adverse effects. It’s as effectiveand safe as Milrinone, while has an advantage over Milrinone in improvingrenal function.5mg Olprinone is as effective as10mg Milrinone.