| Objective:To evaluate the clinical effectiveness in the patients with pulmonary hypertension related to the left heart disease using Isosorbide Dinitrate Injection(Isoket) by comparing with the group using Milrinone on the basis of conventional treatment to heart failure.Methods:The controlled experiment was randomly and positive drug parallel controlled trial. All congestive left heart failure patients who fit the inclusion criteria(Right cardiac catheterization is the golden standard in the diagnosis of pulmonary hypertension related to the left heart diseases, but it’s difficult to popularize in clinical diagnosis because of its invasive, so the Doppler echocardiography is used to diagnosing it) were randomly divided into trial group(Isoket) and control group(Milrinone). The trial group was treated with isoket injection of 0.5 mg/kg in 3 mg/h pumping speed;The control group was treated with Milrinone 50 ug/kg diluted with0.9% sodium chloride solution 20 ml and mainlined in 15 min, 0.65 ug/kg milrinone was diluted to 100 ml and intravenous transfused in 3 hours at the speed of7-8 drops per minute or 0.5 ml/min. Both groups were treated once a day for 5 days.Before and after the therapy, All patients’ clinical symptoms, vital signs,echocardiography, NT-pro BNP and biochemical factor were recorded; during the therapy, all adverse reaction was recorded. Finally, The data were statistically analyzed to compare the two groups’ efficacy.Results:According to the measured pulmonary hypertension, before and after treatment the trial group were 52.63±14.36 mm Hg and 42.67 ±13.54 mm Hg, Comparisons in the group before and after the treatment were statistically significant(P<0.01);the control group were 57.00 ± 17.59 mm Hg and 47.11 ± 19.83 mm Hg,Comparisons in the group before and after the treatment were statistically significant(P < 0.01). According to NYHA heart function classification curative effect assessment, there is no statistically significant difference between the two groups(P> 0.05). The LVEF of trial group before and after the treatment were 35.50% ±10.31% and 41.00 % ± 9.37 %, Comparisons in the group before and after the treatment were statistically significant(P<0.01);In the control group before and after the treatment LVEF were 32.74% ± 11.80% and 38.80% ± 12.65%,Comparisons in the group before and after the treatment were statistically significant(P < 0.01). In the trial group before and after the treatment NT- pro BNP were5335.00(2417.50, 10475.00) ng/ml and 3305.00(1097.00, 5362.50) ng/ml,Comparisons in the group before and after the treatment were statistically significant(P<0.01); In the control group before and after the treatment NT- pro BNP were6880.00(2960.00, 11000.00) ng/ml and 3680.00(1255.00, 6210.00) ng/ml,Comparisons in the group before and after the treatment were statistically significant(P < 0.01). There is no statistical significance between the two groups when comparing the D-value before and after the treatment in PASP, LVEF and NT-pro BNP(P>0.05). There is no statistical significance between the two groups when comparing ALT, AST, creatinine, urea nitrogen, potassium, sodium, chloride,calcium ions(P>0.05); The patients confronted with adverse effects in the trial goup is 3, and is 3 in the controll group, Comparison between the groups were not statistically significant(P>0.05).Conclusion:The short-term application of Isoket or Milrinone all can effectively reduce thepulmonary hypertension and improve heart function index in patients with pulmonary hypertension related to the left heart diseases, and the effect is quite. |
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