口服不同剂量西地那非对新生儿持续性肺动脉高压的临床疗效

Clinical analysis of different doses of sildenafil taken orally in the treatment of neonatal persistent pulmonary hypertension

目的:研究口服不同剂量的西地那非对新生儿持续性肺动脉高压的临床治疗效果。方法:选择2011年2月至2015年12月进行诊治的持续性肺动脉高压新生儿240例,随机分为3组,每组各80例。甲组采用0.3 mg/kg西地那非治疗,乙组采用0.6 mg/kg西地那非治疗,丙组采用1.0 mg/kg西地那非治疗。比较各组患儿的临床治疗效果以及治疗前后的肺动脉压、动脉血氧分压、动脉血氧饱和度、动脉血二氧化碳分压。结果:各组有效率分别为甲组32.50%(26/80)、乙组53.75%(43/80)、丙组81.25%(65/80),其中丙组最高,差异有统计学意义(P<0.05);治疗前各组肺动脉压比较差异无统计学意义(P>0.05),治疗后各组肺动脉压与治疗前比较差异均有统计学意义(P<0.05),各组患儿治疗后的肺动脉压比较差异有统计学意义(F=24.016,P=0.000),且丙组低于其他两组(P<0.05);治疗前各组患儿动脉血氧分压、动脉血氧饱和度、动脉血二氧化碳分压比较差异无统计学意义(P>0.05),治疗后各组患儿的动脉血氧分压比较差异有统计学意义(F=15.267,P=0.000),动脉血氧饱和度比较差异有统计学意义(F=12.054,P=0.000),动脉血二氧化碳分压比较差异有统计学意义(F=16.581,P=0.000),且丙组改善均优于其他两组(P<0.05)。结论:西地那非对新生儿持续性肺动脉高压具有较好的临床治疗效果,随着剂量的增加,患儿的临床效果越好,具有一定的剂量依从关系。

Objective： To analyze the clinical efficacy of different doses of Sildenafil taken orally in the treatment of neonatal persistent pulmonary hypertension. Methods： 240 cases of neonatal persistent pulmonary hypertension hospitalized from February. 2011 to December 2015 were randomly divided into Group A, Group B and Group C, with 80 cases in every group. Group A was treated by 0.3 mg/kg Sildenafil, Group B was treated by 0.6 mg/kg Sildenafil, and Group C was treated by 1.0 mg/kg Sildenafil, with clinical efficacy and the pulmonary artery pressure, arterial partial pressure of oxygen, oxygen saturation, and arterial partial pressure of carbon dioxide before and after treatment among the three groups observed and compared. Results： The effective rate of Group C [81.25 % （65/80） ] was higher than that in Group A [ 32.50 % （26/80） ] and that of Group B [ 53.75 % （43/80） ] （ P 〈 0.05 ）. There was no difference in terms of pulmonary artery pressure among the three groups before treatment （ P 〉0.05）. Compared with that before treatment, there was significant difference in terms of pulmonary artery pressure after treatment （ P 〈0.05 ）. There was significant difference in terms of pulmonmy＂ artery pressure ＂after treatment among the three groups（ F = 24.016, P = 0. 000）, with that of Group C the lowest. ,ks to the arterial partial pressure of ox^cgen, oxygen saturation, and arterial partial pressure of carbon dioxide there was no difference among the three groups before treatment （ P 〉0.05 ）. The difference in terms of arterial partial pressure of oxygen after treatment was （ F = 15. 267, P = 0.000, that of ox- ygen saturation was （ F = 12. 054, P = 0. 000） and that of arterial partial pressure of carbon dioxide was （ F = 16. 581, P = 0. 000）, and the improvement of Group C was better that of the other two groups, the difference being significant, （ P 〈 0.05 ）. Conclusion ： Sildenafil taken orally in the treatment of neonatal persistent pulmonary hypertension has better clinical efficacy, which was promoted with increasing doses and is compliant with doses.