西地那非联合螺内酯治疗肺动脉高压的疗效及对血清N端脑钠肽原C反应蛋白的影响

The clinical efficacy of sildenafil combined with spironolactone in the treatment of pulmonary arterial hypertension and its effect on serum NT-proBNP and CRP

目的观察西地那非联合螺内酯治疗肺动脉高压(PAH)的临床疗效及对血清N端脑钠肽原(NT-proBNP)、C反应蛋白(CRP)水平的影响。方法将30例PAH患者按随机数字表法分成2组,各15例。对照组予西地那非(25mg,3次/d),观察组予西地那非联合螺内酯(20mg,1次/d)。疗程均为12周。分别于治疗前、后检测6min步行距离(6MWD)、世界卫生组织(WHO)心功能分级、超声心动图参数包括[肺动脉收缩压(SPAP)、心输出量(CO)、右心室舒张末压(RVEDP)]及血清NT-proBNP、CRP水平。结果治疗后,对照组和观察组6MWD、SPAP、CO、RVEDP较同组治疗前均明显改善,但观察组改善更显著,差异有统计学意义(P<0.05)。对照组和观察组NT-proBNP、CRP均较同组治疗前明显降低,但观察组降低更显著,差异有统计学意义(P<0.05)。结论西地那非联合螺内酯治疗PAH安全有效,且能明显降低血清NT-proBNP、CRP水平。

Objective To observe the clinical efficacy of sildenafil combined with spironolactone in the treatment of pulmonary arterial hypertension（PAH）and its effect on serum NT-proBNP and CRP.Methods Thirty patients with PAH were randomly divided into 2groups,15 cases in each group.The control group was treated with sildenafil 25 mg tid,the observation group were given sildenafil combined with spironolactone 20 mg qd.The course of treatment was 12 weeks.Before and after treatment,the 6-min walking distance（6MWD）,WHO heart function classification,hemodynamic parameters and NT-proBNP and CRP in serum were detected,and echocardiographic parameters including pulmonary arterial systolic pressure（SPAP）,cardiac output（CO）,right ventricular end diastolic pressure（RVEDP）were also analyzed.Results After treatment,RVEDP,CO,SPAP and6 MWD in the control group and the observation group were significantly improved compared with those of the same group before treatment,but the observation group improved more significantly,the difference was statistically significant（P〈0.05）.NT-proBNP,CRP in the control group and the observation group were significantly lower than that of the same group before treatment,but the observation group was significantly lower,the difference was statistically significant（P〈0.05）.Conclusion Sildenafil combined with spironolactone in the treatment of PAH was safe and effective,and can significantly reduce the levels of NT-proBNP and CRP in serum.