西地那非治疗新生儿持续肺动脉高压临床疗效观察

Effect of Sidenafil in the Treatment of Persistent Pulmonary Hypertension of the Newborn

目的:评价西地那非辅助治疗新生儿持续肺动脉高压(PPHN)的有效性和安全性,为临床应用提供指导。方法:将2008年1月～2011年5月确诊的40例PPHN患儿随机分为治疗组22例和对照组18例,对照组给予保暖、碳酸氢钠碱化血液、积极治疗原发病、常规给氧及呼吸机辅助通气等常规治疗,治疗组在常规治疗的基础上给予枸橼酸西地那非片鼻饲0.6～2.0 mg/(kg.次),每6 h 1次,疗程到停用机械通气,比较两组治疗前后PaCO2、PaO2、肺动脉压力(PAP)、氧合指数(OI)、肺泡气-动脉血氧分压差。结果:西地那非组血气指标明显改善,肺动脉压下降,治疗组PAP和肺动脉/体循环收缩压(PAP/SBP)在治疗后各时点逐步下降,与治疗前比较均明显下降,差异有统计学意义(P<0.05),两组PaO2和OI在治疗后均明显上升,并随着治疗时间延长逐步上升,与治疗前比较差异有统计学意义(P<0.05)。结论:西地那非治疗新生儿PPHN能更好改善患儿的氧合指数、氧饱和度,降低肺动脉压力,其疗效肯定。

Objective：To observe the effect of sidenafil in the treatment of persistent pulmonary hypertension of the newborn（PPHN）.Methods：Among 40 newborns with PPHN,22 cases were treated with sidenafil additionally and 18 cases were treated with the routine treatment only.PH value,PaO2,pulmonary artery pressure（PAP） and oxygenation index（OI） were measured before and after the treatment.Results：After treatment with sidenafil,the clinical manifestations of infants were significantly improved,PAP notably decreased,SpO2 and PaO2 obviously increased,there was a significant difference（P0.05）.Conclusions：Sidenafil is effective in treating PPHN,which can decrease PAP and improve oxygenation index.