丹参酮ⅡA对慢性阻塞性肺疾病继发性肺动脉高压疗效的影响

Effect of Sodium TanshinonⅡA on Pulmonary Arterial Hypertension Secondary to Chronic Obstructive Pulmonary Disease

目的探讨丹参酮ⅡA对慢性阻塞性肺疾病继发性肺动脉高压(COPD-PAH)疗效的影响。方法收集COPD-PAH患者52例,心功能NYHA分级为Ⅱ级,按随机数字表法分为对照组26例,治疗组26例。对照组按照慢性阻塞性肺疾病(COPD)稳定期指南规定治疗(包括吸入长效支气管舒张剂、吸入糖皮质激素、氧疗等),治疗组在对照组的基础上加用丹参酮ⅡA(40mg·d-1,14d)。比较2组患者治疗前后的Brog呼吸困难评分、6min步行距离、肺动脉收缩压(PASP)、血气分析、脑钠肽(BNP)等指标。结果治疗后,治疗组较对照组的6min步行距离明显改善(t=2.235,P=0.030),肺动脉收缩压(PASP)明显下降(t=2.618,P=0.045),脑钠肽水平明显下降(t=0.636,P=0.041)。结论丹参酮ⅡA可以改善COPD-PAH患者的6min步行距离,降低肺动脉收缩压及脑钠肽水平,有可能延缓慢性肺源性心脏病的进展。

Objective To investigate the effect of sodium tanshinonⅡA on pulmonary arterial hypertension secondary to chronic obstructive pulmonary disease（COPD-PAH）.Methods Fiftytwo patients with COPD-PAH（NYHA classⅡ）were randomly divided into two groups,with 26 patients in each group.The control group was given routine treatment according to the Diagnosis and Treatment Guideline for Stable Phase of COPD,including long-acting bronchodilation agent inhalation,glucocorticoid inhalation,oxygen therapy,etc.On the basis of routine treatment,the treatment group was given sodium tanshinonⅡA（40 mg·d-1）for 14 days.The Brog dyspnea score,6-minute walking distance（6MWD）,pulmonary artery systolic pressure（PASP）,blood gas analysis and brain natriuretic peptide（BNP）level were measured before and after treatment.Results Compared with control group,6MWD was improved（t=2.235,P=0.030）,PASP was reduced（t=2.618,P=0.045）,and BNP level was decreased（t=0.636,P=0.041）in treatment group.Conclusion Sodium tanshinonⅡA can improve 6MWD and reduce PASP and BNP level in patients with COPD-PAH,suggesting that it may delay the development of chronic pulmonary heart disease.