阿魏酸哌嗪治疗肺心病急性加重期对肺动脉压、血气分析及血液流变学的影响

Effects of piperazine ferulate on pulmonary arterial blood pressure,blood gas and hemorheology in treating exacerbations of pulmonary heart disease

目的探讨大剂量阿魏酸哌嗪治疗肺心病急性加重患者对肺动脉压、血气分析及血液流变学的影响。方法40例患者随机分成:治疗组(大剂量阿魏酸哌嗪片加常规治疗,n=20)和对照组(常规治疗,n=20),疗程14d,并检测平均肺动脉压(mPAP)、血气分析[氧分压(PaO2)、二氧化碳分压(PaCO2)和动脉血氧饱和度(SaO2)]以及血液流变学(血液粘度、血浆粘度、血液还原粘度和红细胞压积)。结果与治疗前比较,治疗组和对照组治疗后的mPAP、动脉血PaCO2均有下降,动脉血PaO2、SaO2均有升高,差异均有统计学意义(t分别=3.17、3.34、2.86、3.28、2.93、2.32、2.37、2.68,P均<0.05);但对照组治疗后与治疗组治疗后mPAP及PaCO2、动脉血PaO2、SaO2之间的差异均有统计学意义(t分别=2.14、2.78、2.78、3.08,P均<0.05)。两组的血液粘度、血浆粘度、血液还原粘度及红细胞压积与治疗前比较,均有下降,差异均有统计学意义(t分别=3.26、3.03、2.88、2.72、2.78、2.46、2.36、2.67,P均<0.05);对照组与治疗组治疗后血液粘度、血浆粘度、血液还原粘度及红细胞压积之间的比较,降更明显,差异均有统计学意义(t分别=2.24、2.65、2.82、2.37,P均<0.05)。结论常规治疗联用大剂量阿魏酸哌嗪口服可明显改善肺心病患者的肺动脉压和肺通气、换气功能,也能明显改善患者的高凝状态下的血液流变学。

Objective To discuss the effects of large dosage of piperazine ferulate on pulmonary arterial blood pressure,blood gas and hemorheology in treating exacerbations of pulmonary heart disease.Methods Forty patients with exacerbations of pulmonary heart disease were randomly assigned as treatment group（large dosage of Piperazine Ferulate tablets plus routine therapy） and control group（routine therapy）.Each group had 20 cases and received 14 days＇ treatment.Average pulmonary artery blood pressure（mPAP）,partial pressure of oxygen（PaO2）,partial pressure of carbon dioxide（PaCO2）,arterial oxygen saturation（SaO2）,blood viscosity,plasma viscosity,blood reduced viscosity and hematocrit were detected.Results Both the mPAP and PaCO2 of the treatment group and control group were decreased after treatment,both the PaO2 and SaO2 of the treatment group and control group were increased,the differences were statistically significant（t = 3.17,3.34,2.86,3.28,2.93,2.32,2.37,2.68,P 0.05）.After treatment,the differences of mPAP,PaCO2,PaO2 and SaO2 were statistically significant between the two groups（t = 2.14,2.78,2.78,3.08,P 0.05）.The blood viscosity,plasma viscosity,blood reduced viscosity and hematocrit of two groups dropped after treatment,the differences were statistically significant（t = 3.26,3.03,2.88,2.72,2.78,2.46,2.36,2.67,P0.05）.After treatment,the differences of the blood viscosity,plasma viscosity,blood reduced viscosity and hematocrit were statistically significant between the two groups（t =2.24,2.65,2.82,2.37,P0.05）.Conclusions Routine therapy uniting with large oral dosage of piperazine ferulate tablets may obviously improve the pulmonary arterial blood pressure,pulmonary ventilation and pulmonary gas exchange in patients with pulmonary heart disease,as well as the hemorheology under hypercoagulability status.