Clinical Study Of Milrinone Combined With Dopamine In The Treatment Of Refractory Heart Failure

ObjectiveTo investigate the clinical efficacy and safety of milrinone combined with dopamine in the treatment of refractory heart failure.Methods160 patients with refractory heart failure were randomly divided into two groups.The combined drug group(n=80)was treated with milrinone and dopamine,and the single drug group(n=80)was treated with dopamine alone for 7 days.The clinical effects of the two groups were observed,including NT-pro BNP,left ventricular ejection fraction(LVEF),left ventricular ejection fraction before and after treatment.The changes of stroke output(SV),6-minute walking distance(6MWD),adverse drug reactions,and the effects on liver and kidney function after 3 and 7 days of treatment were followed up for 6 months.Rehospitalization rate and mortality were recorded in both groups.Results1.After one week of treatment,the effective rate of the combined drug group was 91.25%(73 cases /80 cases)while the effective rate was 72.50%(58 /80)in the single drug group.By comparison,the effective rate of treatment in the combined drug group was significantly higher than that of the individual drug group(P<0.05).2.Both groups of NT-pro BNP,LVEF,SV value and 6 minutes walking distance were significantly improved after treatment(P<0.05)while there was no significant difference in these aspects between the combined drug group and the single drug group before treatment(P>0.05);moreover,the combined drug group were significantly better than that of the individual drug group after treatment,and the difference was statistically significant(P<0.05).3.Adverse drug reactions occurred in both groups.The incidence of adverse reactions in the combined drug group was 17.5%(14 /80)while the incidence of adverse reactions in individual drug groups was 11.25%(9/80).There was no significant difference between the two groups(P>0.05).4.There was no statistically significant difference in the level of hepatic alanine amino converting enzyme(ALT)and aspartic acid amino converting enzyme(AST)in the treatment of liver function in the two groups before treatment(P>0.05).After treatment,the changes of ALT and AST levels were not obvious,and there was no significant difference between the two groups(P>0.05).5.There was no significant difference in the levels of blood urea nitrogen(BUN)and blood creatinine(Cre)before treatment in the two groups(P>0.05).After treatment,the BUN level,Cre level in the combined drug group and the single drug group did not change significantly,and the difference was not statistically significant(P>0.05).6.Follow-up for 6 months showed that the rehospitalization rate was 17.11%(13/76)in the combined drug group and 31.17%(24/77)in the single drug group,with significant difference between the two groups(P<0.05).The mortality rate in the combined drug group was 11.84%(9/76)and that in the single drug group was 16.88%(13/77),and the difference of mortality between the two groups was not statistically significant(P>0.05).Conclusion1.Milrinone combined with dopamine has a significant clinical effect on refractory heart failure.2.Milrinone combined with dopamine has obvious advantages in improving 6-minute walking distance,LVEF,SV and reducing NT-pro BNP level in patients with refractory heart failure,thus effectively improving the cardiac function of patients.3.Milrinone combined with dopamine is safe for refractory heart failure.4.Milrinone combined with dopamine can significantly reduce the readmission rate of refractory heart failure patients within 6 months,but there was no significant difference in mortality within 6 months between the two groups,and the longer survival rate needs further follow-up.