列素治疗重度特发性肺动脉高压临床疗效

《列素治疗重度特发性肺动脉高压临床疗效》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、中华临床医师杂志(电子版)2012年3月第6卷第6期ChinJClinicians(ElectronicEdition)，March15，2012，v01．6．No．6·论著·静脉注射伊洛前列素治疗重度特发性肺动脉高压临床疗效王广义薛浩朱航邢攸红【摘要】目的观察特发性重度肺动脉高压(IPAH)患者接受静脉注射伊洛前列素治疗的临床疗效。方法16例重度IPAH患者接受静脉注射伊洛前列素，起始量0．5ng·kg一·min持续静滴，根据病情酌情加量至1—2ng·kg～·rain～，治疗时间(21±5)d。观察其对心功能和非侵入性血流动力学参数的影响。结果NYHA心功能级别改善

2、0，8(P<0．01)。非侵入性血流动力学参数明显改善：肺动脉收缩压(sPAP)从(103．7±24．1)mmHg下降至(94．1±13．8)mmHg(P<0．001)；左心室舒张末内径(LVED)从(34．7±9．2)mmHg增加至(37．5±9．8)mmHg(P=0．235)；右心室舒张末内径(RVED)从(46．4±8．9)mmHg下降至(42．6±8．7)mmHg(P=0．181)。每搏输出量治疗前(36．2±16．7)ml，治疗后(37．7±18．4)ml(P=0．891)。动脉血气氧分压和二氧化碳分压轻微增加。血浆B型利钠肽(BNP)浓度较治疗前明显下降[

3、(25008±2500)pg／ml．(11327±1389)PS／ml，P<0．001]。结论静脉注射伊洛前列素能明显降低重度IPAH患者肺动脉压力，改善心功能。【关键词】高血压，肺性；输注，静脉内；伊洛前列素ClinicalefectofintravenousfloprostonsevereidiopathicpulmonaryarterialhypertensionWANGGuang—yi，XUEHao，ZHUHang，XINGYou-hong．DepartmentofCardiology，ChinesePeoplesLiberationArmyGeneralHo

4、spital，Beijing100853，Chinac0玳0author：WANGGuang-yi，Email：gywgyw301@yahoo．coBz．cn【Abstract】ObjectiveToobservetheeffectofintravenousiloprostonsevereidiopathicpulmonaryarterialhypertension(IPAH)．Methods16cases(10femaleand6male)ofsevereIPAHreceivedintravenousiloprostwithdoseof0．5ng·kg～·min～a

5、ttimeofinitiationoftreatment．Accordingtothepatientssymptomsandclinicalcondition，doseofintravenousiloprostwasgraduallyincreasedtothemaximumtolerateddose．Thetimeoftherapywas(21±5)daysTheeffectsofintravenousiloprostonheartfunctionandtheparametemofhemodynamicswereobserved．ResultsHeartfuncti

6、onalclasswasimprovedby0．8classaftertreatmentwithintravenousiloprost．Atthesametime，theparametersofultrasoniceehoeardiographywereimproved：pulmonaryarterialsystolicpressure(sPAP)decreasedfrom(103．7±24．1)mmHgto(94．1±13．8)mmHg(P<0．001)；Leftventricularenddiastolicdiameters(LVED)increased，whil

7、erightventrieularenddiastolicdiameters(RVED)decreased．Strokevolumeincreased．Oxygenpartialpressureandpartialpressureofcarbondioxideofarterialbloodgasincreased．Thelevelofbrainnatriuretiepeptide(BNP)decreasedfrom(25008±2500)pg／mlto(11327±1389)pg／ml(P<0．001)．ConclusionsIntravenousi