西地那非治疗新生儿肺动脉高压的临床效果分析

Clinical Effect Observation on Silaenafil in Treatment of Neonatal Pul-monary Hypertension

目的探讨分析西地那非治疗新生儿肺动脉高压的疗效,丰富临床治疗经验。方法整群选择2013年9月—2015年7月该院收治的新生儿肺动脉高压患儿105例,将所有患者随机分为A组、B组和C组,每组患儿35例,分别给予3组患儿0.5mg/kg、1.0mg/kg以及1.5mg/kg的西地那非,对比3组患儿的治疗有效率、动脉血氧分压和平均肺动脉压的变化情况。结果 A组临床治疗的总有效率是57.1%(20/35),B组临床治疗的总有效率是74.3%(26/35),C组临床治疗的总有效率是91.4%(32/35),随着药物剂量的增多,有效率渐渐提升,差异具有统计学意义(P<0.05);治疗后A、B和C3组平均肺动脉压和动脉血氧分压随着剂量的提升均有显著改善,差异具有统计学意义(P<0.05);A、B和C3组都没有发生心率失常、恶心呕吐、肝功能受损、低血压以及出血等不良反应。结论选取西地那非进行治疗可以显著改良患儿肺动脉高压,临床治疗效果和剂量表现出依从关系,并且剂量的增加未提升不良反应几率,可靠安稳,值得临床进一步推广使用。

Objective To discuss and analyze the curative effect of silaenafil in treatment of neonatal pulmonary hypertension in order to enrich the clinical treatment experience. Methods 105 cases of children with neonatal pulmonary hypertension admitted and treated in our hospital from September 2013 to July 2015 were selected and randomly divided into three groups with 35 cases in each, the group A were given 0.5mg/kg silaenafil, the group B were given 1.0mg/kg silaenafil, the group C were given 1.5mg/kg silaenafil, the treatment effective rate, changes of arterial partial pressure of oxygen and mean pulmonary arterial pressure of the three groups were compared. Results The total clinical treatment effective rate was 57.1%（20/35） in the group A, 74.3%（26/35） in the group B and 91.4%（32/35） in the group C, with the increase of the drug dose,the effective rate was gradually improved, and the difference was obvious,（P〈0.05）, after treatment, the mean pulmonary arterial pressure and arterial partial pressure of the three groups were obviously improved with the increase of the drug dose,and the difference was obvious,（P〈0.05）, the adverse reactions such as arrhythmia, nausea and vomiting, ？liver function lesion, ？hypotension and hemorrhage did not occur to the three groups. Conclusion The choice of silaenafil in treatment of neonatal pulmonary hypertension can obviously improve the pulmonary hypertension of the children, the clinical treatment effect has a compliance relationship with the dose, and the increase of the dose does not increase the probability of adverse reactions, and it is reliable and stable, which is worth further promotion and application in clinic.