贝前列素钠治疗肺源性心脏病肺动脉高压的临床研究

Effect of Beraprost on Pulmonary Heart Disease with Pulmonary Hypertension

目的:观察贝前列素钠治疗肺源性心脏病(肺心病)肺动脉高压的临床疗效。方法:将68例肺心病急性发作期患者随机分为对照组(n=31)和贝前列素钠组(n=37)。两组患者均给予抗感染、止咳、化痰、平喘、强心利尿等常规治疗,贝前列素钠组在上述治疗的基础上加口服贝前列素钠治疗。比较两组疗效和外周动脉压(PABP)、肺动脉压(PAP)、左室射血分数(LVEF)、血脑钠肽(BNP)、血气[酸碱度(pH),氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)]及血清C反应蛋白(CRP)、内皮素-1(ET-1)、一氧化氮(NO)水平变化。结果:贝前列素钠组总有效率明显高于对照组(94.59%vs 77.42%,P<0.05),显效率也显著高于对照组(48.65%vs 16.12%,P<0.01)。治疗后两组PAP、CRP、ET-1、NO、BNP、血气指标较治疗前均明显改善(P<0.05或P<0.01);贝前列素钠组较对照组PAP、PaCO2、ET-1、BNP降低更明显(P<0.01),PaO2、SaO2、NO升高更显著(P<0.01)。结论:贝前列素钠可以明显降低肺心病肺动脉高压患者肺动脉压,改善心功能,这可能与其降低ET-1和提高NO水平有关。

Objective:To observe the clinical efficacy of beraprost on chronic pulmonary heart disease(CPHD)with pulmonary hypertension(PH).Method:68patients were randomly divided into 2groups:conventional treatment group(n=31)and beraprost treatment group(n=37).All patients received the conventional treatments,including:anti-inflammatory,antitussive,expectorant and antiasthmatic and cardiacdiuretic.In addition,the beraprost treatment group received the beraprost.The treatment effect,peripheral arterial blood pressure(PABP),pulmonary artery pressure(PAP),oxygen saturation(SaO2),left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP),blood gas analysis[PH value(PH),partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),oxygen saturation(SaO2)]and serum C reactive protein(CRP),endothelin(ET-1)and nitric oxide(NO)were recorded.Results:The total efficiency of two groups had significant differences(94.59%vs 77.42%,P<0.05),and the obvious effective rate happened in beraprost treatment group(48.65% vs 16.12%,P<0.01).Compared to before treatment,PAP,blood gas analysis results,CRP,ET-1,NO,BNP in both group were significantly improved(P<0.05 or P<0.01),but the LVEF,PAP had no changed(P>0.05).Beraprost treatment group showed lower PAP,PaCO2,ET-1,BNP levels and higher PaO2,SaO2,NO levels(P<0.01).Conclusion:Beraprost could significantly alleviate the pulmonary hypertension,improve cardiac function,which might be related to the reduced serum ET-1levels and increased NO content.