摘要
目的观察内皮素受体拮抗剂波生坦+磷酸二酯酶抑制剂西地那非联合治疗先心病合并重度肺动脉高压的安全性及有效性.方法对2009年1月至2012年8月到昆明医科大学附属延安医院就诊的先心病合并重度肺动脉高压患者进行筛选,符合入组标准者10例,其中男性3例,女性7例,平均年龄(43.04±19.74)岁;均予以波生坦+西地那非联合治疗6月,主要研究终点为WHO肺动脉高压功能分级等临床指标,次要研究终点为肺动脉压力等血流动力学指标.结果波生坦+西地那非联合治疗6月,WHO功能分级等主要研究指标与基线相比较有显著改善,肺动脉压力、心输出量等次要研究指标亦有不同程度改善,同时红细胞、尿酸等理化指标均较治疗前显著好转,上述差异均具有统计学意义(P<0.05);而三尖瓣反流速度、转氨酶等理化指标较治疗前无明显变化;亦未发现影响治疗的严重副反应.结论波生坦+西地那非治疗先天性心脏病合并重度肺动脉高压安全有效.
Objective To evaluate the clinical efficacy and safety of bosentan and sildenafil in the treatment of the severe pulmonary artery hypertension with congenital heart disease. Methods All patients with severe pulmonary hypertension as well as congenital heart disease in our hospital from January 2009 to February 2012 were selected as the object,and ten patients were enrolled,of which,3 cases were male,7 cases were female, the average age was 43.04±19.74 years old. They were all treated with bosentan and sildenafil for 6 months. The main end points were WHO classifications of pulmonary hypertension, and the second end points were hemodynamic indexes such as pulmonary artery pressure.Res ults After treatment for 6 months, there were significant improvements in the main end points including WHO classifications of pulmonary hypertension;there improvements of the second end points such as pulmonary artery pressure and cardiac output; and then there were notable improvement of physical properties for instance red blood cell and uric acid; difference of which had statistical significance. But there were no significant changes in aminotransferase and three tricuspid regurgitation velocity of other physical properties than those of before treatment. No severe side effects and complications were observed. Conclus ion The results reveald the efficacy and safety of oral administration of combining bosentan and sildenafil in the severe pulmonary artery hypertension with congenital heart disease.
出处
《昆明医科大学学报》
CAS
2014年第3期54-57,共4页
Journal of Kunming Medical University
基金
云南省自然科学基金资助项目(2011FB237)
关键词
波生坦
西地那非
先心病
肺动脉高压
安全性
Bosentan
Sildenafil
Congenital heart disease
Pulmonaryarteryhypertension
Safety
