摘要
目的初步观察安立生坦治疗肺动脉高压患者的有效性和安全性。方法采用多中心前瞻性开放性研究,入选2012年8月至2013年2月上海市东方医院、复旦大学附属中山医院、上海市第五人民医院28例肺动脉高压患者(肺动脉高压分类第1和第4大类),给予安立生坦2.5~5.0mg/次、1次/d口服治疗,治疗12周研究结束。分别记录基线资料和治疗12周时的6min步行距离(6MWD)、世界卫生组织心功能分级(WHO—FC分级),检测氨基末端脑钠肽前体(NT—proBNP)、肝功能等。对治疗前后6MWD、WHO—FC分级、NT—proBNP、肝功能变化进行分析。结果入选28例患者,男9例,女19例,平均年龄(35±17)岁。基线6MWD为(372±86)m,WHO—FC分级Ⅱ级11例、Ⅲ级15例、Ⅳ级2例,肝功能均正常。治疗12周后,患者6MWD增至(443±96)m(P=0.000);WHO—FC分级明显改善为I级4例、Ⅱ级18例、Ⅲ级6例(P=0.000);中位NT—proBNP值由基线时的732ng/L降至329ng/L(P=0.046)。治疗后患者肝功能未见明显异常变化。结论安立生坦能明显改善肺动脉高压患者的心功能和运动耐力,安全性和耐受性良好。
Objective To explore the efficacy, safety and tolerance of ambrisentan, a high- selective endothelin receptor antagonist, in Chinese patients with pulmonary hypertension (PH). Methods Twenty-eight PH patients ( Group 1 + Group 4 ) came from Shanghai East Hospital, Zhongshan Hospital of Fudan University and Fifth People's Hospital of Shanghai were recruited into this open-label, prospective multi-center trial between August 2012 and February 2013. They received 2. 5 - 5.0 mg ambrisentan once daily for 12 weeks. The primary endpoint was the change in exercise capacity showed by six-minute walk distance (6MWD) from baseline to 12 weeks. Secondary endpoints included the changes in World Health Organization (WHO) function class, N-terminal brain natriuretic peptide (NT-proBNP) and liver function test results. Results There were 9 males and 19 females with an average age of ( 35 ± 17 ) years. The value of 6MWD increased from ( 372 ±86) m at baseline to ( 443 ±96 ) m ( P =0. 000 ) after 12 weeks. WHO functional class improved after a 12-week therapy compared to the baseline level (P = 0. 000 ). NT-proBNP decreased from a median of 732 ng/L at baseline to 329 ng/L after 12 weeks ( P = 0. 046 ). The baseline liver function test was normal. And liver function test didn't significantly change after a 12-week therapy. Conclusion Ambrisentan therapy is well-tolerated and it improves the exercise capacity and WHO function class in Chinese PH patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第34期2736-2738,共3页
National Medical Journal of China
关键词
高血压
肺性
治疗结果
安立生坦
Hypertension, pulmonary
Treatment outcomes
Ambrisentan