摘要
目的:研究先天性心脏病(CHD)并发重度肺动脉高压(PAH)介入封堵联合盐酸伐地那非综合治疗的应用。方法:术前、后常规给予29例患者口服盐酸伐地那非治疗,对有介入封堵适应证的患者置入封堵器进行试验性封堵测压,若肺动脉压降低幅度为原来压力的20%或下降30mmHg(1mmHg=0.133kPa)以上后进行永久封堵,术后继续采用超声多普勒心动图随访患者肺动脉收缩压(SPAP)、肺循环、体循环收缩压比值(Pp/Ps)、右室大小(RV)、左室射血分数(LVEF)12个月。结果:本组29例患者经术前、后常规予盐酸伐地那非治疗后,27例行介入试验性封堵测压,随后有25例肺动脉压降低幅度为原来压力的20%或下降30mmHg以上。对这25例患者进行永久封堵,且5例使用带孔封堵器,随访12个月,除1例死亡外,其余心功能恢复Ⅰ级以上、动脉血氧饱和度(SaO2)均恢复在0.95以上、SPAP、Pp/Ps、LVEF、RV均有显著改善(均P<0.05)。4例无法封堵的患者除1例转心外科手术后死亡外,其余心功能由Ⅳ级恢复到Ⅲ级、SaO2在0.90以上、动脉血氧分压>60mmHg。结论:介入试验性封堵联合盐酸伐地那非综合治疗微创、简便、安全、可靠,给CHD并发重度PAH的患者带来根治的希望。
To explore the effect of interventional therapy combinated with vardenafil in congenital heart disease （CHD） with severe pulmonary hypertension （PAH）. Method：Twenty-nine patients received vardenafil before and after the interventional therapy. Pulmonary systolic pressure （SPAP）, the ratio of pulmonary/systemic systolic pressure （Pp/Ps）, right ventricular （RV）, and left ventrieular ejection fraction （LVEF）were followed by echocardiography for 12 months. Result：Twenty-nine patients received vardenafil before and after operation, which twenty-seven cases with indications of interventional therapy were measured SPAP. Twenty-five cases pulmonary artery pressure decreased 20M or 30 mmHg and underwent the interventional therapy successfully. Except one died, other patients heart function had reeoveried over grade Ⅰ , arterial oxygen saturation （SaO2） had recoveried more than 0. 95, SPAP, Pp/Ps, LVEF and RV had significantly improved （P〈0.05）. Four cases without indica-tions of interventional therapy, except one died by surgical treatment, the others heart function had recoveried from grade IV to grade Ⅲ, arterial oxygen saturation （SaO2） had recoveried more than 0.95, arteries partial pres-sure of oxygen （PaO2） 〉 60 mmHg. Conclusion： The interventional therapy combined with vardenafil is a micro-trauma, effective and safe method for the treatment of CHD with severe PAH.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2012年第7期514-517,共4页
Journal of Clinical Cardiology
