前列腺素E_1在先天性心脏病肺动脉高压中的作用及对血浆ET-1的影响

The effect of prostaglandin E_1 in pulmonary hypertension with congenital heart diease and blood plasma endothelin-1

目的探讨前列腺素E1在先天性心脏病肺动脉高压中的作用及对血浆ET-1的影响。方法对48例先天性心脏病合并肺动脉高压患儿应用前列腺素E1静脉微泵维持共两周,并同时采用放免法检测患儿用药前后血浆ET-1的变化。结果(1)应用前列腺素E1后患儿血浆ET-1浓度、肺动脉平均压较用药前明显降低,而血氧饱和度明显升高(P<0.05)。(2)副作用主要表现为发热(10/48),部分患儿出现呼吸暂停/伴心率下降(5/48),1例患儿出现低血压。结论前列腺素E1通过降低患儿血浆ET-1及肺动脉平均压有效改善血氧饱和度,减轻临床症状;经密切观察及对症处理,其副作用轻微,在儿童中应用安全可行。

Aim To investigate the function of prostaglandin E1 in pulmonary hypertension with congenital heart diease and the effect on blood plasma endothelin-1. Method 48 eases with pulmonary hypertension were administered PGEI for two weeks and the level of endothelin-1 was measured by using radioimmulogie assay. Results （ 1 ）The level of endothelin-1 and pulmonary artery mean pressure were distinctly lower than those before administered,and the oxygen saturation was notably increased（ P 〈0.05 ）. （2）The side effects mostly represented fever（ 10/48 ）, some patients having apnea or bradyeadia（ 5/48 ）, one patient representing hypotension. Conclusion PGE1 ameliorated oxygen saturation by reducing the level of endothelin-1 and pulmonary artery mean pressure and alleviated clinical symptom; The side effects were mild by observation and treating and it was safe to use PGE1 in ehidren.