西地那非治疗新生儿缺氧性肺动脉高压的疗效及对患者血清HIF-1α、ET-1、iNOS浓度的影响

Effect of sildenafil on neonatal hypoxic pulmonary hypertension and its influence on serum HIF-1alpha, ET-1 and iNOS levels

目的探讨西地那非治疗新生儿缺氧性肺动脉高压疗效及对患者血清HIF-1α、ET-1、iNOS浓度的影响。方法选取HPH患儿50例以疾病严重程度分为轻型HPH组28例、重型HPH组22例。另选取无HPH症状新生儿40例为正常对照组。HPH患儿均行常规治疗及西地那非治疗,并比较治疗前及治疗后1天、3天、7天的血气指标、血清蛋白因子及疗效。结果HPH组患儿血气指标随治疗时间延长逐渐好转,且不同时点各血气指标两两比较差异均有统计学意义(P<0.05),治疗后7天恢复正常,其中轻型HPH组治疗后7天与对照组相比,差异无统计学意义(P>0.05)。两组患儿血清蛋白因子随治疗时间延长逐渐好转,且两组不同时点各血清蛋白因子两两比较,差异均有统计学意义(P<0.05),治疗后7天恢复正常,其中轻型HPH组治疗后7天与对照组相比,差异无统计学意义(P>0.05)。重型HPH组总有效率为90.91%,轻型HPH组总有效率为96.43%,两者差异无统计学意义(P>0.05)。结论西地那非对新生儿缺氧性肺动脉高压疗效明显,可有效改善mPAP、PaO 2、PaO 2/FiO 2及血清HIF-1α、ET-1、iNOS浓度。

Objective To investigate the efficacy of sildenafil in treatment of neonatal hypoxic pulmonary hypertension and its effect on serum HIF-1a, ET-1 and iNOS levels. Methods 50 children with HPH diagnosed in our hospital from January 2016 to June 2018 were divided into the mild HPH group(28 cases) and the severe HPH group (22 cases). Another 40 newborns without HPH symptoms were selected as the normal control group. All the children were treated with routine therapy and sildenafil. The blood gas index,serum protein factor and curative effect were compared before treatment and 1,3 and 7 days after treatment. Results The blood gas indexes of the two groups gradually improved with the prolongation of treatment time,and there were significant differences between the two groups at different time points( P < 0.05). The blood gas indexes returned to normal 7 days after treatment. There was no significant difference between the light HPH group and the control group 7 days after treatment( P > 0.05).The serum protein factors of the two groups gradually improved with the prolongation of treatment time,and there were significant differences between the two groups at different time points( P < 0.05). The serum protein factors returned to normal 7 days after treatment. There was no significant difference between the light HPH group and the control group 7 days after treatment( P > 0.05). The total effective rate was 90.91% in the severe HPH group and 96.43% in the light HPH group. There was no significant difference between the two groups( P > 0.05). Conclusion Sildenafil is effective in treating neonatal hypoxic pulmonary hypertension,which can effectively improve the concentration of m PAP,PaO2,PaO2/FiO2 and serum HIF-1a,ET-1 and iNOS.