西地那非治疗新生儿持续肺动脉高压的疗效观察

Efficacy of sildenafil on persistent pulmonary hypertension in the newborn infants

目的探讨西地那非治疗新生儿持续肺动脉高压的疗效与安全性。方法2005年1月至2008年10月本院新生儿重症监护室收治的持续肺动脉高压患儿45例，其中男25例、女20例，平均胎龄（39．3±2．4）周，平均出生体质量（3114．0±10．2）g，入院时平均年龄（13．0±0．8）h。将以上病例随机分为西地那非、妥拉苏林和米力农治疗3组。利用超声心动图仪检测肺动脉压力。结果45例患儿中，治愈30例，好转6例，无效9例，总有效率80．0％；西地那非、妥拉苏林和米力农3组患儿的治疗有效率相同；3组患儿治疗前后平均肺动脉压力下降，差异有显著性（P〈0．05），3组间比较则无显著性（P〉0．05）。所有患儿在治疗过程中均未见不良反应。结论西地那非对于新生儿持续肺动脉高压具有良好的治疗效果，可有效降低平均肺动脉压力，改善心功能。

Objective To investigate the efficacy and side effect of sildenafil in the treatment of persistent pulmonary hypertension of the newborn （PPHN）. Methods Forty-five cases with PPHN were collected from Jan 2005 to Oct 2008 in NICU of Children＇s Hospital Affiliated to Shanghai Jiaotong University. Twenty-five patients were male and 20 female. Their gestational age was（39. 3 ±2. 4） weeks ,birth weight was （3 114. 0 ± 10. 2） g,and the age was（ 13. 0 ±0. 8） hours old. All cases were not assisted with ventilator. The patients were randomly assigned to be treated with sildenafil ,tolazoline and milrione. The pulmonary artery pressure （PAP） was measured by echocardiography. Results The PPHN were cured in 30 cases,significantly improved in 6 cases,unchanged in 9 cases. The total efficacy was 80%. There were no significant difference of efficacy among 3 groups. However,the PAP reduced after being treated with sildenafil,tolazoline and milrione （P 〈0. 05）. No side effect happened in all patients treated with the three drugs. Conclusion Sildenafil is an effective and safe drug to reduce PAP of PPHN and also help to improve cardiac function of the newborn infants.