目的 探讨米力农注射液联合伊洛前列素治疗小儿先天性心脏病肺动脉高压（CHD-PAH）的临床疗效。方法 选取2014年2月-2015年2月在郑州市儿童医院接受治疗的CHD-PAH患者64例，随机分为对照组（32例）和治疗组（32例）。对照组患者口腔雾化吸入吸入用伊洛前列素溶液，10 μg混于生理盐水2 mL，10 min/次，6次/d。治疗组在对照组的基础上静脉注射米力农注射液，50 μg/kg溶于葡萄糖溶液20 mL，缓慢注射5~10 min，然后0.5 μg/kg的剂量溶于生理盐水50mL，持续泵入3 h。两组患者均连续治疗14 d。比较两组患者治疗前后临床疗效、血氧饱和度（SpO₂）、Borg评分、心脏功能分级（NYHAFC）、脑钠尿肽（BNP）以及右心导管检查结果。结果 治疗后，对照组和治疗组的总有效率分别为75.00%和93.75%，两组总有效率比较差异有统计学意义（P<0.05）。治疗后，两组患者SpO₂均明显增加（P<0.05）；且治疗后治疗组增加更明显（P<0.05）。治疗后，两组Borg评分、NYHAFC、BNP均显著降低（P<0.05）；且治疗组上述指标降低程度优于对照组（P<0.05）。治疗后，两组肺动脉收缩压（sPAP）、肺动脉平均压（mPAP）、肺动脉收缩压/体循环收缩压（Pp/Ps）均明显降低，同时肺循环血流量/体循环血流量（Qp/Qs）比例升高，同组治疗前后比较差异具有统计学意义（P<0.05）；且治疗组上述指标改善优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 米力农注射液联合伊洛前列素治疗小儿CHD-PAH的效果显著，有利于患者心功能的改善，具有一定的临床推广应用价值。

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.