【摘要】 目的探讨前列地尔联合西地那非治疗肺动脉高压(PAH)的临床疗效。方法 80例PAH患者随机分为观察组(n=40)与对照组(n=40),所有患者给予强心、利尿、扩血管等常规治疗,观察组在上述基础上加用西地那非及前列地尔治疗,比较两组治疗前后心脏功能、肺功能及血气分析指标变化及不良反应。结果两组患者治疗前肺动脉宽度(PA)、左心室射血分数(LVEF)及肺动脉压(SPAP)水平无显著差异,治疗后两组患者PA、SPAP降低,LVEF增高(P<0.05),治疗后观察组PA、SPAP低于对照组(P<0.05),LVEF高于对照组(P<0.05);治疗前两组患者肺活量预计值(VC%)、动脉氧分压(PaO2)及6 min步行距离无明显差异,治疗后两组VC%、PaO2及6 min步行距离均显著增高(P<0.05),治疗后观察组VC%、PaO2及6 min步行距离显著高于对照组(P<0.05),两组患者均未出现严重不良反应。结论前列地尔联合西地那非治疗PAH可有效改善心肺功能,降低肺动脉压,改善临床治疗效果。更多还原

【Abstract】 Objective To discuss the clinical effect of alprostadil combined with silaenafil in the treatment of pul monary hypertension(PAH).Methods Eighty cases with PAH were randomly divided into 40 cases of the observation group and 40 cases of the control group.All patients were given conventional therapy,such as cardiac stimulant,diuresis,enlarging blood vessel.The observation group was added alprostadil combined with silaenafil on the basis of conventional therapy.The changes of cardiac function,pulmonary function and blood gas analysis index before and af ter the treatment and adverse reactions of two groups were compared.Results There were not significant differences in the levels of pulmonary artery width,left ventricular ejection fraction,pulmonary arterial pressure before the treatment between two groups.The levels of pulmonary artery width and pulmonary arterial pressure of two groups after the treatment decreased,and the level of left ventricular ejection fraction increased(P < 0.05).Compared with in the control group,the levels of pulmonary artery width and pulmonary arterial pressure in the observation group after the treatment decreased(P < 0.05),and the level of left ventricular ejection fraction increased(P < 0.05);There were not significant difference in percentage of predicted value of vital capacity(VC%),arterial oxygen pressure(PaO2) and 6 minutes walk before the treatment between two groups.The VC%,PaO2 and 6 minutes walk of two groups after the treatment increased significantly(P < 0.05),and the VC%,PaO2and 6 minutes walk of the observation group after the treatment were higher than those of the control group(P < 0.05).No severe adverse reactions of two groups happened.Conclusion Alprostadil combined with silaenafil in the treatment of PAH can effectively improve cardiac function and pul monary function,decrease pulmonary arterial pressure,and improve clinical treatment effect.更多还原