目的 探討米力農(nóng)注射液聯(lián)合伊洛前列素治療小兒先天性心臟病肺動脈高壓（CHD-PAH）的臨床療效。方法 選取2014年2月-2015年2月在鄭州市兒童醫(yī)院接受治療的CHD-PAH患者64例，隨機(jī)分為對照組（32例）和治療組（32例）。對照組患者口腔霧化吸入吸入用伊洛前列素溶液，10 μg混于生理鹽水2 mL，10 min/次，6次/d。治療組在對照組的基礎(chǔ)上靜脈注射米力農(nóng)注射液，50 μg/kg溶于葡萄糖溶液20 mL，緩慢注射5~10 min，然后0.5 μg/kg的劑量溶于生理鹽水50mL，持續(xù)泵入3 h。兩組患者均連續(xù)治療14 d。比較兩組患者治療前后臨床療效、血氧飽和度（SpO₂）、Borg評分、心臟功能分級（NYHAFC）、腦鈉尿肽（BNP）以及右心導(dǎo)管檢查結(jié)果。結(jié)果 治療后，對照組和治療組的總有效率分別為75.00%和93.75%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者SpO₂均明顯增加（P<0.05）；且治療后治療組增加更明顯（P<0.05）。治療后，兩組Borg評分、NYHAFC、BNP均顯著降低（P<0.05）；且治療組上述指標(biāo)降低程度優(yōu)于對照組（P<0.05）。治療后，兩組肺動脈收縮壓（sPAP）、肺動脈平均壓（mPAP）、肺動脈收縮壓/體循環(huán)收縮壓（Pp/Ps）均明顯降低，同時(shí)肺循環(huán)血流量/體循環(huán)血流量（Qp/Qs）比例升高，同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組上述指標(biāo)改善優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 米力農(nóng)注射液聯(lián)合伊洛前列素治療小兒CHD-PAH的效果顯著，有利于患者心功能的改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Milrinone Injection combined with iloprost in treatment of children with congenital heart disease with pulmonary hypertension (CHD-PAH). Methods Children (64 cases) with CHD-PAH in Children's Hospital of Zhengzhou from February 2014 to February 2015 were randomly divided into control (32 cases) and treatment (32 cases) groups. Children in the control group were orally atomizing inhalation administered with Iloprost Solution for inhalation, 10 μg mixed into normal saline 2 mL, 10 min/time, six times daily. Children in the treatment group were iv administered with Milrinone Injection on the basis of the control group, 50 μg/kg added into glucose solution 20 mL, slow injection for 5-10 min, then 0.5 μg/kg·dissolved into normal saline 50 mL, and continuous pumping for 3 h. Children in two groups were treated for 14 d. After treatment, the clinical efficacy, SpO₂, Borg score, NYHAFC, BNP, and right heart catheterization Results in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.00% and 93.75%, respectively, and there was difference between two groups (P<0.05). After treatment, SpO₂ in two groups were significantly increased (P<0.05). And SpO₂ in the treatment group was increased more significantly than that in the control group (P<0.05). After treatment, Borg, NYHAFC, and BNP in two groups were significantly decreased (P<0.05). And these indicators in the treatment group were significantly better than those in the control group (P<0.05). After treatment, sPAP, mPAP, and Pp/Ps in two groups after treatment were significantly decreased, and Qp/Qs was increased, and the difference was statistically significant in the same group (P<0.05). And these indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Milrinone Injection combined with iloprost has a good effect in treatment of children with CHD-PAH, can significantly improve the patient's heart function, which has a certain clinical application value.