Kubo S H, Cody R J, Chatterjee K, Simonton C, Rutman H, Leonard D
Am J Cardiol. 1985 Mar 1;55(6):726-30. doi: 10.1016/0002-9149(85)90145-6.
To determine the magnitude and time course of the optimal acute hemodynamic response to oral milrinone, an ascending dose range study was performed in 34 patients with severe chronic congestive heart failure (2.5 to 10 mg, n = 21; 7.5 to 15 mg, n = 13). With the 7.5- and 10-mg doses in both groups, cardiac index increased 26%, pulmonary capillary wedge pressure decreased 25% and systemic vascular resistance decreased 20%, with peak effect at 90 minutes. The hemodynamic improvement with 10 mg was sufficient to normalize cardiac index in 29% of patients. There was a clear dose-response relation, with the largest increases of cardiac index seen with the 15-mg dose (1.67 +/- 0.10 to 2.31 +/- 0.11; p less than 0.005). This dose-response relation was confirmed by the correlation of drug levels and change in cardiac index. However, some patients had significant hypotension and tachycardia with the 15-mg dose. Thus, although 10 mg appears to be optimal for most patients, the dose of milrinone should be individualized for all patients.
为确定口服米力农后最佳急性血流动力学反应的程度和时间过程，对34例严重慢性充血性心力衰竭患者进行了剂量递增研究（2.5至10毫克，n = 21；7.5至15毫克，n = 13）。两组使用7.5毫克和10毫克剂量时，心脏指数增加26%，肺毛细血管楔压降低25%，全身血管阻力降低20%，90分钟时达到峰值效应。10毫克剂量时的血流动力学改善足以使29%的患者心脏指数恢复正常。存在明显的剂量反应关系，15毫克剂量时心脏指数升高幅度最大（1.67±0.10至2.31±0.11；p<0.005）。药物水平与心脏指数变化的相关性证实了这种剂量反应关系。然而，部分患者使用15毫克剂量时出现显著低血压和心动过速。因此，虽然10毫克剂量对大多数患者似乎是最佳的，但米力农剂量应针对所有患者个体化。
