Lipo-PGEl与酚妥拉明治疗先天性心脏病重度肺动脉高压术前疗效观察

Comparison of intravenous Lipo-prostaglandin El and regitine in treatment of severe pulmonary artery hypertension associated with congenital heart disease before cardiac surgery

目的比较静脉应用凯时与酚妥拉明治疗分流型先天性心脏病(CHD)重度肺动脉高压(PAH)的术前疗效。方法48例重度PAH患者随机分为A、B、C、D四组:A组基础治疗(包括休息、间断氧气吸入、应用利尿剂及地高辛等),为对照组;B组基础治疗和静脉泵入酚妥拉明;C组基础治疗和静脉泵入前列腺素E1脂微球载体制剂(Lipo-PGE1);D组基础治疗、静脉泵入酚妥拉明后泵入Lipo-PGE1。检测统计治疗2周前、后病人的肺动脉收缩压(PASP)、体循环收缩压(ASP)及动脉血气分析氧分压(PaO2)、氧饱和度(SaO2)。结果与A组相比,B、C、D组在降低PASP及提高PaO2、SaO2方面差异均具有统计学意义(P<0.05),D组较B、C组作用更明显(P<0.01)。结论Lipo-PGE1和酚妥拉明均有效降低重度PAH患者肺动脉压,两药联合应用效果更为显著。联合应用Lipo-PGE1和酚妥拉明治疗PAH是一种较理想的选择。

Objective To compare the effects of treatment of intravenous lipo - prostaglandin E1 （ Lipo - PGE1） and regitine on the preoperative pulmonary artery hypertension （PAH） associated with congenital heart disease （CHD）. Methods Forty - eight patients complicated with severe PAH were randomly divided into four groups （ n = 12, each group）. For group A give general treatment including rest on the bed, inhaled oxygen intermittently, using diuretic and digoxin etc; group B：general treatment and regitine which was infused; group C：general treatment and Lipo -PGE1 which was infused; group D：general treatment, regitine and Lipo - PGE1. The changes of pulmonary arterial systolic pressure（ PASP）, arterial blood gas, lung static compliance and aortic systolic pressure （ASD）were measured respectively before and after drugs were given. Results After 2 weeks of treatment, data shows that group D have more significant effect than group A,B and C on reducing the PASP（P 〈0.01 ）. At the same time,the groups B and C have more significant effect than group A on reducing the PASP （P 〈 0.05 ）. Conclusions Both intravenous Lipo - PGE1 and regitine could significantly alleviate PAH. But the two medicine combined with eath other have more significant effect than that used respectively on reducing the PASP. So the treatment combined with Lipo - PGE1 and regitine is regarded as a ideal method.