西地那非联合阿托伐他汀钙治疗COPD相关肺动脉高压的疗效探讨

The Efficacy Observation of Sidenafil Combined with Atorvastatin Calcium Used for Patients with Pulmonary Arterial Hypertension Caused by Chronic Obstructive Pulmonary Disease

目的探讨西地那非联合阿托伐他汀钙治疗COPD相关的肺动脉高压的疗效及安全性。方法整群选取88例稳定期COPD相关性肺动脉高压(CHD-PAH)患者为研究对象,分为西地那非联合阿托伐他汀组(A组n=30),西地那非组(B组n=27),传统治疗组(C组n=33),连续治疗6个月。治疗前后均采取心脏超声心动图检测右室收缩压(RVSP)、右心室收缩末期内径(RVSD),同时观察动脉血氧分压(Pa O2)、血氧饱和度(Sa O2)、肺功能[观察指标FEV1/FVC]、6 min步行距离(6-MWD)、肝功能、肌酸激酶同工酶(CK-MB)。结果 1与治疗前比较,治疗后A、B组RVSD缩小,RVSP下降,FEV1/FVC、Pa O2及6-MWD增加,差异有统计学意义(P<0.05),C组无明显变化;2与B组比较,治疗后A组RVSP、6-MWD变化更加显著,已显示出额外获益(P<0.05)。结论西地那非联合阿托伐他汀治疗可以显著改善COPD相关的肺动脉高压患者活动耐力,降低RVSP,无严重不良反应发生。

Objective To explore the efficacy and safety of Sidenafil combined with Atorvastatin Calcium used for patients with pulmonary arterial hypertension caused by chronic obstructive pulmonary disease（COPD）. Methods Select 88 cases of patients with pulmonary arterial hypertension caused by chronic obstructive pulmonary disease （CHD-PAH）, who are in stable stage, as the re-search object. In detail, select 30 patients treated by Sidenafil combined with Atorvastatin as group A, 27 patients treated only by Sidenafil as group B, 33 patients treated by traditional method as group C, all patients with continuous treatment for six months. Before and after treatment, detect the right ventricular systolic blood pressure （RVSP） and right ventricular end systolic diameter （RVSD） by echocardiography, with the observation of arterial blood oxygen partial pressure （PaO2）, blood oxygen saturation （SaO2）, lung function （choosing FEV1/FVC as the observational index）, 6 minutes walking distance （6-MWD）, liver function and creatine kinase-MB （CK-MB）. Results①Compared with the indexes before treatment, the RVSD and RVSP of group A and B shrunk and declined after treatment, FEV1/FVC, PaO2 and 6-MWD increased after treatment, all with statistical significance （P〈0.05）, but no obvious changes in group C. ②Compared with group B, the RVSP and 6-MWD of group A shows more significant changes after treatment, and have shown an additional benefit （P〈0.05）. Conclusion The therapy of Sidenafil combined with Atorvastatin can markedly improve the activity endurance of the patients with pulmonary arterial hypertension caused by COPD, lower the RVSP, without any serious adverse events.