| Objective:The researches of phosphodiesteraseⅢinhibitor for curing chronic congestive heart failure have been a focus point. Olprinone is a new PDEⅢ inhibitor, which was recently discovered. Comparing with milrinone, this research will evaluate olprinone’s clinical efficacy and safety for curing heart failure.Methods:20patients with severe heart failure of the second hospital of Shan Xi Medical University were involved in this research, they all satisfied the inclusion criteria and were hospitalized during August2011to March2012. Then they were randomly separated into two groups:the treatment group and the control group, each with ten patients. With the standard treatments of heart failure (the inotropic medicine was not included), the two groups were treated with olprinone or milrinone for consecutive five days. Here are the details for doses and usage:the treatment group, olprinone hydrochloride, firstly the amount of10μg/kg of olprinone which was diluted with normal saline to20ml was slowly intravenous injected (5～10minutes), then the amount of0.25μ g/kg per minute diluting with normal saline or glucose solution to100ml was given by intravenous drip with the rate of0.5ml or7～8drops per minute for3hours; the control group, milrinone injection, firstly the amount of50μg/kg milrinone which was diluted with normal saline to20ml was slowly intravenous injected (5～10minutes), then the amount of0.65μg/kg per minute diluting with normal saline or glucose solution to100ml was given by intravenous drip with the rate of0.5ml or7～8drops per minute for3hours. Before and after treatment, the cardiac function (NYHA heart function classification, Boston scores) and the indexes of cardiac Doppler ultrasound were observed. At the same time, we also must pay attention to the incidence of adverse reactions during the treatment and the period of follow-up visit. The data were examined by chi-square test and t test. P<0.05was considered to be statistic significant.Results:There was significant statistics difference between before and after treatment in NYHA cardiac function classification and Boston scores of the two groups (P<0.05). The symptoms of patients with heart failure after treatment notably improved comparing with before treatment. As for NYHA cardiac function classification, the total effective rate of treatment group was80%, the control group90%; Boston scores, the total effective rate of treatment group was40%, the control group50%. There was no significant difference between two groups in NYHA cardiac function classification or Boston scores (P>0.05). We did not find any significant improvements in indexes of cardiac Doppler ultrasound [LVEDD (left ventricular end-diastolic dimension), LVEDV (left ventricular end-diastolic volume), LVESS(left ventricular end-systolic dimension), EF(left ventricular ejection fraction), FS (fractional shortening), left ventricular filling index(Peak E, Peak A, left atrial diameter), CO(cardiac output), SV(stroke volume), CI(cardiac index)] and there was no significant difference between before and after treatment (P>0.05). The adverse reaction was not observed in control group. In the treatment group, during the treatment, the sinus bradycardia occurred on one case. But we can not sure that the sinus braycardia was induced by olprinone, and there was not significant difference between two groups in adverse reaction (P>0.05).Conclusion:Treatment of olprinone with small dose and short-term application can notably improve the symptoms of patients with severe heart failure, and there was no significant difference in clinical efficacy comparing with milrinone. In this research, we have not identified that olprinone can effectively improve the indexes of cardiac Doppler ultrasound. And we also have not observed any adverse reaction except one case with sinus bradycardia treated with olprinone. As there was no adverse reaction such as sinus bradydardia was reported, we considered that the sinus brsdycardia might be induced by the progression of the disease itself. |
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