贝前列素钠对慢性左心衰竭合并肺动脉高压患者的影响

Effects of beraprost sodium on patients with chronic left heart failure combined with pulmonary arterial hypertension

目的探讨贝前列素钠对慢性左心衰竭合并肺动脉高压患者的疗效和安全性。方法选择慢性左心衰竭合并肺动脉高压患者50例,采用随机数字表法分成两组,分别给予常规治疗(常规组)和常规治疗基础上加贝前列素钠治疗(贝前列素钠,口服,每次40μg,每日3次),疗程12周。对所有患者进行基线评估,包括美国纽约心脏病学会(NYHA)分级、6 min步行距离(6MWT)、Borg呼吸困难评分、心肺血流动力学参数及脑钠肽(BNP)等,治疗随访12周后重复上述检查。结果与常规组比较,贝前列素钠组治疗12周后NYHA功能分级、6MWT[(350±106)m比(320±101)m]、Borg呼吸困难评分[(3.0±2.4)分比(3.8±2.6)分]、肺动脉收缩压[(56±13)mm Hg比(67±15)mm Hg]、平均肺动脉压[(33±6)mm Hg比(40±8)mmHg]和肺循环阻力[(3.5±1.5)WU比(4.6±1.6)WU]及肺毛细血管楔压均明显改善,差异有统计学意义(P<0.05)。药物相关不良反应:贝前列素钠组用药初期1例患者有头痛伴面部潮红,1例患者出现恶心、呕吐,均可耐受,1周后症状消失。结论贝前列素钠可改善慢性左心衰竭合并肺动脉高压患者的运动耐力、心肺血流动力学参数和临床症状且安全。

Objective To explore the effect and safety of Beraprost sodium in patients with chronic left heart failure and pulmonary arterial hypertension. Methods Totally 50 cases with chronic left heart failure and pulmonary arterial hypertension were selected in this study. They were randomly assigned into two groups by using random number table method. Conventional group was given routine treatment and BPS group on the basis of routine treatment was treated with Beraprost sodium which was used orally,every time 40 μg,3 times a day. Patients in every group received relevant medicine for 12 weeks. Baseline assessments including New York heart association（NYHA） grading,6-min walk test（6 MWT）,Borg dyspnea score,cardiopulmonary hemodynamic parameters and brain natriuretic peptide（BNP） were recorded and followed up for 12 weeks. Results NYHA grading,6 MWT [（350 ± 106） m vs（320 ± 101） m],Borg dyspnea score [（3. 0 ± 2. 4） min vs（3. 8 ± 2. 6） min],pulmonary artery pressure [（56 ± 13） mm Hg vs（67 ± 15） mm Hg）,pulmonary artery pressure [（33 ± 6） mm Hg vs（40 ± 8） mm Hg],pulmonary vascular resistance [（3. 5 ± 1. 5） WU vs（4. 6 ± 1. 6） WU]and pulmonary capillary wedge pressure were significantly improved in BSP group after 12 weeks of treatment compared with those in conventional group;the differences were statistically significant（P 〈 0. 05）. Beraprost-related adverse events were as follows：one case had headaches with facial flushing,one case had nausea and vomiting in BSP group at preliminary stage of treatment;all of them were tolerable and the symptoms disappeared after 1 week. Conclusions Beraprost sodium improves exercise capacity,cardiopulmonary hemodynamic parameters and clinical symptoms of patients with left heart failure and pulmonary arterial hypertension and it is safe.