| [Objective]Olprinone is a new generation of phosphodiesterase inhibitor following Amrinone and Milrinone which increaseas muscle strength scarely increases heart rate and leads to vessel expansion obviously. BNP belongs to NP family, rapidly secreted by heart ventricle while ventricular wall pressure increased. The release of BNP is in direct proportion to the expansion ability of heart ventricle volume and the overload degree of heart ventricle pressure,Therefore the level of BNP reveals the degree of heart function damage or heart failure. As a marker to elucidate diagnosis or treatment of CHF, BNP has been accepted by many authors and clinical doctors. This study use Milrinone as a contrast drug, analyzed the level of BNP、 liver and renal function、 blood and urine routine examination、 ECG、 color Doppler ultrasound parameters、chest x-ray、 the grading of NYHA cardiac function and the quantitative assessment of Boston before and after treatment to estimate safety and effectiveness of Olprinone in treatment of CHF. Observed the changing trend of BNP before and after treatment in control group and test group; analyzed the relationship between re-hospitalization and BNP half year follow-up.[Methods]Random,single blind and positive drug parallel comparison used in this study. There are52CHF patients participated in this study. They were devided randomly to two groups:test group (Olprinone26patients) and control group (Milrinone26patients). color Doppler ultrasound parameters (LVEDD, LVEDV, LVSDD, LVESV, LVEF, LVFS, PeaKE, PeaKA) were collected before the trial, BNP、 liver and renal function、 blood and urine routine examination、ECG、 chest x-ray, general state and heart function of patients have been recorded (Boston score and NYHA), adverse reactions also be recorded. Comparing the diversity of each indicators in order to estimate the effectiveness and safety of Olprinone. Cadiovascular events (Deterioration, Recurrence, Death) recorded in half year after discharge from hospital[Results]After five days treatment, we found there were no difference between olprinone and milrinone in treatment of congestive heart failure (P>0.05). The results were assessed as follows:the effective rate of olprinone was88.46%, while the effective rate of milrinone was84.62%estimated by grading of NYHA; the effective rate of olprinone was61.54%while Milrinone was57.69%estimated by grading of Boston; There are statistic differences of BNP、LVEF in two groups before and after treatment (P<0.05):BNP dropped from (568.46±215.59) pg/ml to (293.5±172.36) pg/ml, EF rised from (42.92±7.01)%to(47.27±8.56)%in control group;BNP dropped from(552.0±246.89) pg/ml to (260.23±161.06) pg/ml, EF rised from (41.00±11.10)%to (46.73±11.05)%in test group;but there were no difference between two groups in curative effect(P>0.05). There were significant differences between two groups in hemoglobin(P<0.05): in control group rised from (132.62±13.09) g/1to(138.04±12.79) g/1, while hemoglobin rised from(132.08±18.86)g/1to (140.73±21.99) g/1in test group. In control group,there is no statistical significance with PLT which rised from (149.50±47.72)*109to (161.00±49.62)*10g while rised from (160.12±60.74)*109to (184.08±67.00)*109in test group, there were significant between two groups(P<0.05). There were no significant difference between ALT、 AST、 BUN、 CR in two groups (P>0.05). There were no statistical significance between two groups in adverse reactions:3patients in control group,2in test group; After half year, there are7patients deteriorated in control group and6patients in test group, but which have no statistical significance(P>0.05). BNP after treatment in control group in the heart failure recurrence groups with the stability groups have statistic difference(P<0.05), but test group have no statistical significance(P>0.05),the average of BNP after treatment in two groups in the heart failure recurrence surpassed330pg/ml. [Conclusion]1、 Olprinone can relieve the clinical symptoms of heart failure effectively after short term administration.2、 Olprinone has no influence on liver function, kidney function and electrolytes, while have statistical significant influence on amount of platelets and hemoglobin.3、 Compared to Milrinone, Olprinone induced fewer adverse reactions but there were no statistical difference in this study.4、 As to the diversity of BNP, there were statistic difference before and after treatment in two groups;5、 Compared to Milrinone, Olprinone has fewer recurrence in half year, but there were no statistical significance in this study.BNP after treatment in control group in the heart failure recurrence groups with the stability groups have statistic difference, but test group have no statistical significance. |
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