Clinical Evaluation Of Milrinone With Low Molecular Weight Heparin On Pulmonary Heart Disease

Objective:Chronic pulmonary heart disease caused by pulmonary vascular changes, chronicdiseases or thoracic structure and (or) dysfunction, resulting in pulmonary vascularresistance increased, pulmonary artery pressure increased, the right ventricular dilatation or(and) hypertrophy, with or without right ventricular failure. It is the end stage for a varietylung disease. The prevalence of chronic pulmonary heart disease increases year by year,makes an impact on the quality of life and prognosis of patients with chronic lung disease,and makes heavy burden of social and economic. The study by allaying results ofechocardiography, D-dimer, blood gas analysis, lung function changes and improvement ofclinical symptoms before and after treatment to evaluate milrinone with low molecularweight heparin on pulmonary heart disease.Method:120patients of pulmonary heart disease were divided into four groups randomly:control group, low molecular weight heparin, milrinone group, the combined treatmentgroup. Each group were given conventional oxygen, antibiotics, expectorant, asthma,maintain water and electrolyte balance, supportive care，plus diuretics, cardiac, andrespiratory stimulants vasoactive drugs. On this basis, low molecular weight heparin grouptreated with low molecular weight heparin (You Nishu) subcutaneous injection; milrinonegroup treated with intravenous infusion of milrinone; combined treatment group treatedwith intravenous infusion of milrinone and low molecular heparin (You Nishu)subcutaneous injection. Before treatment and10days after， to analysis results ofechocardiography, D-dimer, blood gas analysis, lung function changes and improvement ofclinical symptoms. Using statistical software SPSS16.0to processes data. The data aremean±standard deviation (x±s), groups were compared using t test, with P <0.05wasconsidered statistically significant. Results:Ten days after treatment of chronic pulmonary heart disease, the clinical symptoms inthe combined treatment group, milrinone group and low molecular weight heparin groupsignificantly improved than in the control group,(total effective rate:93.3%vs53.3%,80.0%vs53.3%and73.3%vs53.3%), the total effective rate was significant difference (P<0.05). Right ventricular ejection fraction and pulmonary blood flow acceleration time (AT)extended. The ratio of before the right ventricular ejection time (RPEP) and rightventricular ejection time (RVET) decreased. Combined treatment group are better thanmilrinone group, low molecular weight heparin group on improvement of clinicalsymptoms and echocardiography, D-dimer, blood gas analysis, lung function and otherindicators, but milrinone group and low molecular weight heparin no significant differencein the indicators.Conclusion:It has significantly improvement on clinical symptoms, clinical signs and biochemicalfor pulmonary heart disease treated with phosphodiesterase inhibitors3and low molecularweight heparin on the basis of general treatment. Phosphodiesterase inhibitor3drugs(milrinone) can dilate coronary artery and pulmonary artery to reduce pulmonary arterialpressure. Addition of low molecular weight heparin treatment can improve blood viscosityand blood rheology effectively, to prevent thrombosis, improve the ability of tissue touptake and use oxygen, improve oxygenation, alleviate hypercapnia and improve lungfunction, which can improve the oxygen and carbon dioxide retention, heart and lungfunction and improve symptoms and signs significantly, has positive effect on improvingclinical outcomes and reduce mortality..