安立生坦在先天性心脏病术后肺动脉高压中的治疗效果

Ambrisentan in treatment of pulmonary hypertension after surgery for congenital heart disease

目的：评估安立生坦在先天性心脏病术后肺动脉高压中的治疗效果。方法： 我们选取2013年2月-12月70例先天性心脏病术后肺动脉高压的患者。随机分为试药组（n=35）和对照组（n=35）。试药组给予安立生坦＋常规治疗，对照组仅给予常规治疗。12周后患者门诊随访，评估心功能状况、行心脏彩超评估肺动脉压力，并化验检测肝肾功能指标。结果： 试药组［（38±5） mmHg vs.（50±6） mmHg,P〈0.05］和对照组［（41±6） mmHg vs.（47±7） mmHg,P〈0.05］患者术后12周肺动脉压力较术后第3天均明显降低，尽管如此，试药组肺动脉压力降低幅度明显大于对照组［（12±4） mmHg vs.（6±3） mmHg,P〈0.05］。试药组患者中30例（86%）心功能明显改善，对照组中25例（71%）心功能明显改善,两者有显著差异（P〈0.05）。试药组患者未见肝功能损害及贫血病例。结论： 先天性心脏病术后肺动脉高压的患者使用安立生坦能够安全有效地降低肺动脉压力，改善心功能。

AIM：To evaluate the effect of ambrisentan on pulmonary hypertension after the surgery of congenital heart disease. METHODS： Seventy patients with pulmonary hypertension after surgery for congenital heart disease from February to December 2013 were selected. Patients were randomly divided into experimental group （n=35） and control group （n=35）. The experimental group received the combined treatment of ambrisentan and conventional therapy, whereas the control group received conventional therapy only. Outpatient follow-up was conducted in all patients after 12 weeks and cardiac function was assessed by evaluation of pulmonary artery pressure using cardiac ultrasound. Liver and kidney function were also measured. RESULTS： Pulmonary artery pressure in both experimental groups [（38±5） vs.（50±6） mmHg, P〈0.05] and control group （41±6） vs.（47±7） mmHg, P〈0.05] after 12 weeks significantly decreased compared with the values 3 days after surgery. However, decrease of pulmonary artery pressure in the experimental group was remarkably greater than in the control group [（12±4） vs.（6±3） mmHg, P〈0.05]. More improved cardiac functions were observed in 30 patients in the experimental group （86%） than in 25 patients in the control group （71%）. No cases of liver damage and anemia were observed in both groups. CONCLUSION： Application of ambrisentan in patients with pulmonary hypertension after surgery for congenital heart disease is safe and effective in reducing pulmonary artery pressure and improving cardiac functions.