前列地尔注射液对高原地区慢性阻塞性肺疾病相关肺动脉高压患者的影响

Impact of Alprostadil Injection on Patients with Chronic Obstructive Pulmonary Disease Related Pulmonary Arterial Hypertension in Plateau Area

目的探讨前列地尔注射液治疗高原地区慢性阻塞性肺疾病(COPD)相关肺动脉高压(PH)患者的影响。方法选取2015—2016年咸阳市第一人民医院收治的高原地区COPD相关PH患者82例,采用随机数字表法分为对照组与观察组,每组41例。对照组患者予以常规治疗,观察组患者在常规治疗基础上加用前列地尔注射液治疗;两组患者均连续治疗2周。比较两组患者治疗前后6分钟步行距离、平均肺动脉压、血液流变学指标(全血高切黏度、全血低切黏度、纤维蛋白原),并观察两组患者治疗期间不良反应发生情况。结果治疗前两组患者6分钟步行距离、平均肺动脉压比较,差异无统计学意义(P>0.05);治疗后观察组患者6分钟步行距离长于对照组,平均肺动脉压低于对照组(P<0.05)。治疗前两组患者全血高切黏度、全血低切黏度、纤维蛋白原比较,差异无统计学意义(P>0.05);治疗后观察组患者全血高切黏度、全血低切黏度、纤维蛋白原低于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论前列地尔注射液可有效提高高原地区COPD相关PH患者运动耐量,降低患者肺动脉压并改善其血液流变学指标,且安全性较高。

Objective To investigate the impact of alprostadil injection on patients with chronic obstructive pulmonary disease related pulmonary arterial hypertension in plateau area. Methods A total of 82 patients with chronic obstructive pulmonary disease related pulmonary arterial hypertension were selected in the First Peopled Hospital of Xianyang from 2015 to 2016, all of them are living in plateau area and they were divided into control group and observation group according to random number table, each of 41 cases. Patients of control group received conventional treatment, while patients of observation group received extra alprostadil injection based on conventional treatment; both groups continuously treated for 2 weeks. 6 - minute walking distance, MPAP and index of hemorheology （ including whole high - shear blood viscosity, whole low - shear blood viscosity and fibrinogen） before and after treatment were compared between the two groups, and incidence of adverse reactions was observed during the treatment. Results No statistically significant differences of 6 - minute walking distance or MPAP was found between the two groups before treatment （ P 〉 0. 05 ） ; after treatment, 6 - minute walking distance of observation group was statistically significantly longer than that of control group, while MPAP of observation group was statistically significantly lower than that of control group （尸 〈0. 0 5 ） . No statistically significant differences of whole high - shear blood viscosity, whole low - shear blood viscosity or fibrinogen was found between the two groups before treatment （ P 〉 0. 05 ） , while whole high - shear blood viscosity, whole low - shear blood viscosity and fibrinogen of observation group were statistically significantly lower than those of control group after treatment （P 〈 0. 05 ） . No statistically significant differences of incidence of adverse reactions was found between the two groups during the treatment （ P 〉 0. 05 ） . Conclusion Alprostadil injection can effectively improve the exercise tolerance and index of hemorheology, and reduce pulmonary artery pressure in patients with chronic obstructive pulmonary disease related pulmonary arterial hypertension in plateau area.