法舒地尔对室间隔缺损术后持续性肺动脉高压的作用

【摘要】 目的明确长期应用法舒地尔雾化吸入对室间隔缺损术后持续难治性肺动脉高压的治疗作用。方法选择室间隔缺损术后常规治疗6个月仍然持续中度以上肺动脉高压的患者,按照年龄和性别匹配随机分为两组,除常规治疗外,治疗组给予法舒地尔100mg雾化吸入,2次/d,持续12个月,对照组给予同等剂量生理盐水雾化吸入。治疗后3、6、12个月行多普勒超声心动图仪测量肺动脉收缩压(PASP)、左心室射血分数(LVEF)、右心室射血分数(RVEF)和血氧分压(PaO2)。结果与对照组相比,治疗组PASP第6个月时明显降低(P<0.01),第12个月继续降低(P<0.01);LVEF6个月时显著升高,至第12个月时仍然持续升高;RVEF第3个月时即明显升高(P<0.05),至第6、12个月时仍持续升高(P<0.01);PaO2第6个月时升高(P<0.05),第12个月时仍持续升高(P<0.05)。对照组3年生存率为87.5%,5年生存率为62.5%,治疗组5年生存率为100%。结论长期法舒地尔雾化吸入,能显著降低室间隔手术后持续难治性肺动脉高压患者肺动脉收缩压,提升心功能,降低死亡率。更多还原

【Abstract】 Objective The effects of fasudil on refractory pulmonary arterial hypertension after surgery for ventricular septal defect. Objective To evaluate the therapeutic effects of fasudil on refractory pulmonary arterial hypertension(PAH)after surgery for ventricular septal defect. Methods Seventeen ventricular septal defect patients with postoperational refractory PAH after surgery for ventricular septal defect were randomly divided into control group(n=9,2 months of normal saline inhalation plus conventional therapy) and treatment group(n=8,12 months of fasudil inhalation plus conventional therapy). The PASP,RVEF,and LVEF were measured by echocardiography before and 3,6,and 12 months after the treatment. PaO2was monitored. Results Cumulative survival rate in the control group were 87.5% at 3 years and 62.5% at 5 years,while that in the treatment group was 100% at 5 years. Compared with the control group,PASP of patients in the treatment group decreased significantly at 6 and 12 months after fasudil treatment(P <0.01),LVEF and PaO2of patients in the treatment group increased significantly at 6 and 12months(P <0.01); while RVEF of patients in the treatment group showed significant increase at 3 months(P <0.05)and continued to increase at 6 and 12 months(P <0.01). Conclusions Fasudil inhalation therapy after corrective surgery for ventricular septal defect was associated with a reduction in pulmonary arterial systolic pressure,increase of heart function and lower risk of death.更多还原