【摘要】 目的探讨他达拉非联合波生坦治疗先天性心脏病手术后肺动脉高压患者的临床价值。方法选取深圳市孙逸仙心血管医院2015年1月至2016年3月先天性心脏病手术后肺动脉高压患者86例为研究对象,经随机数字表法分为观察组与对照组,每组43例。对照组给予波生坦治疗,观察组在对照组基础上加用他达拉非治疗。观察两组治疗效果、心功能变化及不良反应发生情况。结果观察组治疗总有效率显著高于对照组,差异有统计学意义(95.35%vs.81.40%,P<0.05)。两组治疗前心功能指标比较,差异无统计学意义(P>0.05);治疗后两组均有改善。观察组治疗后左心室射血分数(LVEF)明显高于对照组,左心室舒张末期内径(LVEDD)、血浆N末端脑钠肽前体(NT-proBNP)浓度明显低于对照组,差异有统计学意义(P<0.05)。观察组与对照组用药后不良反应发生率比较,差异无统计学意义(4.65%vs.9.30%,P>0.05);未见严重不良反应。结论先天性心脏病术后肺动脉高压患者接受他达拉非联合波生坦治疗,可有效降低肺动脉压,改善心功能,且安全性高,值得推广。更多还原

【Abstract】 Objectives To probe into the clinical value of tadalafil combined with bosentan in patients with pulmonaryhypertension after operation of congenital heart disease. Methods Totally 86 patients with pulmonary hypertensionafter congenital heart disease surgery in Sun Yat-sen Cardiovascular Hospital from January 2015 to March 2016 wereselected,and were randomly divided into observation group and control group by the random number table method,with 43 cases in each group. In control group,patients were given bosentan treatment,while in observation group,onthe basis of the treatment in control group,patients were treated with the tadalafil. Treatment effect,cardiac functionand adverse reaction of the two groups were observed and compared. Results Total effective rate in observation groupwas significantly higher than that in control group(95.35% vs. 81.40%,P<0.05). There was no significant differencein cardiac function before treatment between the two groups(P>0.05);after treatment,cardiac function of the twogroups significantly improved. Left ventricular ejection fraction(LVEF)in observation group was significantly higherthan that in control group,but left ventricular end diastolic diameter(LVEDD)and serum concentration of N-terminalpro-brain natriuretic peptide(NT-pro BNP)were significantly lower than those in control group,the differences werestatistically significant(P<0.05). Incidence of adverse reactions was not statistically significant between observationgroup and control group(4.65% vs. 9.30%,P>0.05),and there was no serious adverse reactions. Conclusions Treat-ment of tadalafil combined with bosentan in patients with pulmonary hypertension after operation of congenital heartdisease can effectively reduce pulmonary artery pressure,improve heart function with high security,thus it is worthpromoting.更多还原