Objective To investigate the effect of milrinone on cardiac function and renin-angiotensin-aldosterone system in patients with heart failure .Methods Total of 108 patients with heart failure admitted to Beijing Shunyi District Hospital from May 2013 to Jun.2015 were included in the study and divided into control group and observation group by drawing method,54 cases each.The control group was given conven-tional heart failure medications,and the observation group was given milrinone therapy combined with con-ventional drug,firstly a loading dose of 37.5 μg/kg,intravenous infusion after dilution,for about 10 min,and then,with a dose of 0.5 μg/(kg· min) continuous intravenous infusion 24 h,continuous use for 7 d.Serum N terminal brain natriuretic peptide precursor(NT-proBNP),renin activity,aldosterone,left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter (LVESD),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF), cardiac output(CO),stroke volume per minute(SV),maximum filling volume of left ventricle/left atrium ( E/A) levels and other indicators of the two groups were observed .Results After treatment,the total effec-tive rate of the observation group was significantly higher than the control group [ 92.59% ( 50/54 ) vs 75.93% (41/54)] the difference was statistically significant (P<0.05).After treatment,NT-proBNP and renin activity,aldosterone of the observation group were significantly higher than the control group [ (3728 ± 255) ng/L vs (2188 ±56) ng/L,(1.94 ±0.51) μg/(L· h) vs (1.29 ±0.27) μg/(L· h),(97.6 ± 6.3) μg/L vs (83.4 ±1.6) μg/L],the differences were statistically significant (P <0.05); LVEF,SV, CO of the observation group were lower than the control group [(43.6 ±1.4)% vs (51.9 ±1.6)%,(43.6 ± 1.9) mL vs (59.2 ±1.9) mL,(4.09 ±0.14) L/min vs (4.98 ±0.29) L/min],the differences were sta-tistically significant(P<0.01).After treatment,the left ventricular morphology index of the two groups were roughly equal,the difference was not statistically significant(P>0.05).Conclusion Milrinone has a very significant effect in treatment of heart failure patients , which can effectively improve the clinical symptoms and signs,and promote the recovery of cardiac function in patients,inhibit the renin-angiotensin-aldosterone system activity to some extent,and ultimately achieve the therapeutic effect,thus is worthy of clinical applica-tion.%目的：探讨米力农对心力衰竭患者心功能指标及肾素-血管紧张素-醛固酮系统的影响。方法选择2013年5月至2015年6月北京市顺义区医院收治的心力衰竭患者108例，依据抽签法分为对照组和观察组，各54例。对照组采用常规心力衰竭药物治疗，而观察组实施米力农联合常规药物治疗，首先进行负荷剂量37.5μg／kg，稀释后静脉滴注，约10 min，随后，以剂量为0.5μg／（kg· min）持续静脉泵入24 h，持续使用7 d。观察两组心力衰竭患者的血清N端脑钠肽前体（ NT-proBNP）、肾素活度、醛固酮、左心室舒张末期内径（ LVEDD）、左心室收缩末期内径（ LVESD）、左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）、心输出量（CO）、每分钟搏出量（SV）、左心室最大充盈量比左心房最大充盈量（E／A）等指标水平。结果治疗后，观察组患者的总有效率为92.59％（50／54），显著高于对照组75.93％（41／54），差异有统计学意义（P＜0.05）。治疗后，观察组NT-proBNP和肾素活度、醛固酮水平显著高于对照组[（3728±255） ng／L 比（2188±56） ng／L，（1.94±0.51）μg／（L· h）比（1.29±0.27）μg／（L· h），（97.6±6.3）μg／L 比（83.4±1.6）μg／L]，差异有统计学意义（P＜0.01）；观察组LVEF、SV、CO显著低于对照组[（43.6±1.4）％比（51.9±1.6）％，（43.6±1.9） mL比（59.2±1.9） mL，（4.09±0.14） L／min比（4.98±0.29） L／min]，差异有统计学意义（P ＜0.01）。治疗前后，两组患者的左心室形态学指标差异无统计学意义（P ＞0.05）。结论米力农治疗心力衰竭患者具有十分显著的效果，可有效改善患者的临床症状和体征，促进患者心功能指标的恢复，一定程度上抑制肾素-血管紧张素-醛固酮系统的活性，最终达到有效治疗的作用，值得临床应用。
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