西地那非联合硫酸镁治疗新生儿持续性肺动脉高压效果分析及JNK通路蛋白的参与研究

The alleviations of sildenafil on persistent pulmonary hypertension in newborns and its regulations on serum JNK signaling pathway related proteins

目的 对西地那非联合硫酸镁治疗新生儿持续性肺动脉高压的效果及JNK通路蛋白的参与作用进行研究。方法 选2010年6月至2015年12月期间诊治的240例新生儿持续性肺动脉高压患者,随机分将其为三组,每组80例。西地那非治疗组患儿给予西地那非0.5-2.0 mg/（kg·次）,q6h,口服;硫酸镁治疗组患儿采用硫酸镁进行治疗,200 mg/（kg·次）,30 min内静脉滴注;西地那非联合硫酸镁治疗组患儿给予西地那非[0.5-2.0 mg/（kg·次）],q6h,口服）联合硫酸镁[200 mg/（kg·次）,30 min内静脉滴注]进行治疗。三组均给药至肺动脉压力明显降低后停用。分析西地那非及硫酸镁治疗效果及治疗前后血清中JNK通路蛋白的表达变化。结果 西地那非及硫酸镁治疗新生儿持续性肺动脉高压后动脉压氧分压明显升高（P〈0.05）,而二氧化碳分压、肺动脉压力水平降低（P〈0.05）,血清中一氧化氮合酶i NOS、e NOS水平明显升高（P〈0.05）,而JNK1、JNK2、内皮素及其受体、脂氧合酶同工酶1（LOX1）和缺氧诱导因子-1α（HIF1α）水平明显降低（P〈0.05）,且西地那非联合硫酸镁治疗组变化最明显（P〈0.05）。结论 西地那非联合硫酸镁对新生儿持续性肺动脉高压有显著的治疗效果,此过程可能与JNK通路蛋白的参与相关。

Objective Aim The present research aimed to explore the alleviations of sildenafil on persistent pulmonary hypertension in newborns and its regulations on serum JNK signaling pathway related proteins. Methods 240 cases of persistent pulmonary hypertension in new- borns in our department from Jun 2010 to Dec 2015 were enrolled in this part. They were randomly divided into three groups, 80 eases in each group. Sildenafil sildenafil group were given 0.5 - 2.0 mg/kg/times, q6h, oral; Magnesium sulfate group were treated with magnesium sulfate treatment, 200 mg/kg/times, intravenous infusion within 30 min; children combined with magnesium sulfate treatment group received sildenafil sildenafil combined with magnesium sulfate treatment. Three groups were administered to the pulmonary artery pressure decreased significantly disabled. The effect of sildenafil, MgSO4 and sildenafil combined MgSO4 were assayed. The serum JNK related proteins were also be assayed. Restilts The results showed that the PO2 were increased greatly while the PCO2 were increased significantly （ P 〈 0.05）. The results also showed that the serum iNOS, Enos were increased significantly while the JNK1, JNK2, endothelin and its receptor, LOX1 and HIF1α were decreased dramatically after the medication of drug （ P 〈 0.05 ）. However, the results revealed that those parameters were changed more obviously in sildenafil combined MgSO4 group patients （ P 〈 0.05 ）. Conclusion Sildenafil combined MgSO4 is effective in alleviating persistent pulmonary hypertension in newborns which maybe related with the regulation of JNK signaling pathway related proteins.