摘要
目的:探讨醛固酮受体拮抗剂在肺动脉高压患者中的应用疗效。方法:入选特发性肺动脉高压(16例)、先天性心脏病相关性肺动脉高压(11例)及结缔组织病相关性肺动脉高压(7例)患者,予波生坦口服12周。联合治疗组(18例)在此基础上加用螺内酯。分别于治疗前及治疗12周时进行6min步行距离、血流动力学参数评价。结果:波生坦治疗12周后,患者6 min步行距离由(330.18±82.93)m增加至(355.00±77.74)m(P<0.001),脑钠肽(BNP)及C反应蛋白(CRP)水平显著下降。波生坦联合螺内酯治疗使患者的平均肺动脉压下降至(50.83±12.58)mmHg(1mmHg=0.133kPa)(P<0.001),6 min步行距离增加至(382.46±77.28)m(P<0.001),心指数增加至(2.67±0.24)L·min-1·m-2(P<0.001),较波生坦单药治疗改善更为显著。结论:波生坦联合螺内酯可进一步改善肺动脉高压患者的运动耐量和血流动力学参数,并且安全性及耐受性良好。
Objective：To investigate the preliminary efficacy and safety of combination administration of bosen- tan and spirolactone in patients with pulmonary arterial hypertension （PAH）. Method： A total of 34 patients with PAH, idiopathic or associated with congenital heart disease or connective tissue disease were randomly assigned to receive bosentan only or combination with spirolactone. At 12th week, all patients underwent 6 min walk test, he- modynamic variables examination, right heart catheterization,and ultrasound cardiography. Result：After 12 weeks bosentan treatment, the 6 minute walking distance was （355.00 ± 77.74） m, significantly shorter than that after combination therapy with spirolactone （382.46 ± 77.28） m （P〈O. 001）. The cardiac index was （2.48 ± 0.32） L ·min^-1· m^-2, significantly lower than that after combination therapy[（2.67 ± 0.24）L ·min^-1· m^-2] （P= 0. 026）. The mean pulmonary arterial pressure was （55.36±12.98）mmHg （1 mmHg=0. 133 kPa）, significantly higher than that after combination therapy [（50.83± 12.58）mmHg] （P〈0. 026）. Conclusion：Combination thera- py of bosentan and spirolactone improves the exercise tolerance and hemodynamic parameters in PAH patients. The combination therapy is safe in treating PAH and can be well tolerated.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2014年第12期1108-1111,共4页
Journal of Clinical Cardiology
关键词
肺动脉高压
内皮素受体拮抗剂
醛固酮
螺内酯
pulmonary arterial hypertension
endothelin receptor blocker
aldosterone
spirolactone
