前列腺素E1治疗左向右分流先天性心脏病并肺动脉高压的临床研究

Inhaled prostaglandin E1 for the treatment of pulmonary hypertension secondary to congenital heart disease with left-to-rlght shunt

目的观察雾化吸入前列腺素E1（PGE1）对左向右分流型先天性心脏病并肺动脉高压患儿的疗效，探讨治疗肺动脉高压的新途径。方法40例患儿分为PGE1雾化吸入治疗组（n=20）和静脉治疗组（n=20），分别于治疗前及治疗后测量肺动脉平均压、肺动脉收缩压、心指数以及Tei指数的变化。结果应用PGE1治疗后，两组肺动脉平均压、肺动脉收缩压、Tei指数均明显下降，心指数较治疗前增大；两组间治疗前后各指标分别比较，差异无显著性（P均〉0．05）。结论PGE1雾化吸入和静脉给药途径均可使肺动脉压下降，临床症状明显改善，而雾化吸入途径较静脉途径更简便、安全。

Objective To evaluate the effects of prostaglandin EI（PGE1） on pulmonary hypertension （PH） secondary to left to right shunting congenital heart disease. Methods Forty patients with PH were di- vided into PGE1 inhalation group （ n = 20） and PGE1 infusion group （ n = 20）. Right pre-ejection period （RPEP）, ratio of RPEP to acceleration time（AT）, pulmonary artery systolic pressure （PASP）, pulmonary artery mean pressure （PAMP）, cardiac index（CI） and Tei index were evaluated. Results PAMP, PASP and Tei index were obviously decreased and CI was increased, after PGE1 therapy. Additionally, clinical symptoms were improved after using PGE1 in both group. However, there was no significant difference between PGE1 inhalation group and infusion group（ P 〉0.05）. Conclusion Both inhaled and intravenous PGEI can lower pulmonary artery pressure and relieve clinical symptoms. However, inhaled PGEI may be more convenient and safer for the treatment of pH secondary to congenital heart disease.