硝苯地平治疗慢性阻塞性肺病和原发性肺动脉高压远期效应临床研究

Niter Benzene Even Treatment Chronicity Blocking Pulmonarytuberculosis and Primary Pulmonary Artery High Pressure Forward Effect Clinical Research

目的观察硝苯地平对慢性阻塞性肺病(COPD)和原发性肺动脉高压(PPH)远期疗效。方法用随机双盲、有安慰剂对照的设计方法,观察了硝苯地平对COPD和PPH患者[肺动脉压(PAP)和肺循环阻力(PVR)下降幅值;临床症状呼吸困难与运动量改善程度以及长期服用后对病人生存期的影响]的2年疗效。在148例患者中,治疗组100例(硝苯地平10mg,每月3次),安慰剂组48例(1片,每日3次)。在长期治疗中,硝苯地平剂量根据患者的反应进行调整,剂量通常随治疗时间每2个月增加1次,每次增加5mg/d,并观察其疗效,用右心导管法和超声心动图检查法对治疗组患者进行三尖瓣跨瓣压(△P)和心排出量(CO)。随访期间每6个月用超声心动图检查法复查上述指标1次。结果COPD和PPH患者长期用硝苯地平治疗后,△P由(84.1±24.1)mmHg(1mmHg=0.133kPa)降至62.7±18.27mmHg(P<0.01),CO由(4.00±1.22)L/min升至(4.70±1.22)L/min(P<0.02),△P/CO由22.8±9.4降至14.9±6.5(P<0.01)。结论长期口服硝苯地平治疗COPD和PPH,可使患者右心室压力逐渐降低,CO增加,临床症状与运动量改善,并可延长患者生命。

Objective The observation niter benzene puts down to the chronic blockingpulmonary tuberculosis （COPD） and the primary pulmonary artery highpressure （PPH） the forward curative effect. Methods Stochastic double is blind, has the design method which theplacebo compares, observed the niter benzene to put down to COPD andthe PPH patient [ the pulmonary artery presses （PAP） and the pulmonarycirculation resistance （PVR） drops the peak -to- peak value; Theclinical symptom has difficulty in breathing as well as takes for along time after the physiological load of exercise improvement degreeto the patient lifetime influence] 2 years curative effect. In 148 examples patients, treatment group 100 examples （niter benzeneeven 10mg, each month of 3）, placebo group 48 examples （1 piece, everyday 3）. In the long - term treatment, the niter benzene even dosagecarries on the adjustment according to patient＇ s response, the dosageusually increases a time along with the treatment time every 2 months,each time increases the 5mg/day, and observes its curative effect,and the ultrasonic cardiogram inspection method to treatsthe group patient with the right heart to carry on the tricuspid valvecross petal to press （ A P） and the cardiac output （CO）. Makes a follow -up visit the period every 6 months to reexamine abovetarget with the ultrasonic cardiogram inspection method. Results COPDand the PPH patient evenly treats for a long time after the niterbenzene, △ P （1mmHg=0.133kpa） falls by （84.1±24.1） mmHgsends（62.7±18.27mmHg （P〈0.01）, CO rises by （4.00±1.22） L/min to send（4.70±1.22） L/min （P〈0.02）, A P/CO by 22.8±9.4 falls sends 14.9±6.5 （P 〈0.01）. Conclusion Takes orally the niter benzene evenly to treat COPD andPPH for a long time, may cause the patient right ventricle pressuregradually to reduce, CO increases, the clinical symptom and thephysiological load of exercise improvement, and may lengthen thepatient life.