波生坦联合曲前列尼尔对持续肺动脉高压新生儿红细胞分布宽度及血清褪黑素的影响

Effects of Bosentan Combined with Treprostinil on Red Blood Cell Distribution Width and Serum Melatonin in Neonates with Persistent Pulmonary Hypertension

目的:探讨波生坦联合曲前列尼尔治疗新生儿持续肺动脉高压(PPHN)的疗效及对红细胞分布宽度、血清褪黑素表达水平的影响。方法:选取2017年1月至2020年2月黄河三门峡医院收治的PPHN患儿88例,采用随机数表法分为观察组和对照组各44例。对照组患儿给予曲前列尼尔注射液治疗,观察组在对照组治疗基础上口服波生坦治疗,观察两组患儿临床疗效、治疗前后动脉血气指标、红细胞分布宽度、血清褪黑素表达水平及不良反应发生情况。结果:观察组患儿治疗后总有效率高于对照组(P<0.05)。治疗后,两组患儿动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))及血清褪黑素表达水平均高于治疗前(P<0.05),且观察组高于对照组(P<0.05);两组患儿动脉血二氧化碳分压(PaCO_(2))、红细胞分布宽度低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。两组患儿治疗期间均未发生心律失常、肝肾功能损伤、皮肤瘀点瘀斑、出血等不良反应。结论:波生坦联合曲前列尼尔能明显改善PPHN患儿动脉血气指标,降低红细胞分布宽度,提高血清褪黑素表达水平及改善临床疗效,且安全性较高,值得临床推广。

Objective:To explore the effects of bosentan combined with treprostinil on red blood cell distribution width and serum melatonin expression level in neonates with persistent pulmonary hypertension(PPHN).Methods:A total of 88 children with PPHN admitted into Sanmenxia Hospital of the Yellow River from Jan.2017 to Feb.2020 were extracted to be divided into the observation group and the control group via the random number table,with 44 cases in each group.The control group was given treprostinil injection,while the observation group was treated with oral bosentan on the basis of the control group.Clinical efficacy,arterial blood gas indicators,red blood cell distribution width and serum melatonin expression level before and after treatment,and occurrence of adverse drug reactions in two groups were observed.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,arterial partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))and serum melatonin expression level in two groups were significantly higher than those before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).The arterial partial pressure of carbon dioxide(PaCO_(2))level and red blood cell distribution width in two groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).There were no adverse drug reactions such as arrhythmia,liver and kidney function damage,skin ecchymosis and bleeding in two groups.Conclusion:Bosentan combined with treprostanil can significantly improve the arterial blood gas indicators,reduce the red blood cell distribution width,increase the serum melatonin expression level and improve the clinical efficacy with higher safety.It is worthy of clinical promotion.