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目的:探讨贝前列素钠和西地那非治疗肺动脉高压的疗效及安全性。方法:连续入选符合标准的肺动脉高压患者44例(男7例,女37例,年龄27~69岁),随机分为贝前列素钠组(15例)、西地那非组(13例)和联合用药组(16例),分别给予贝前列素钠、西地那非单药以及二者联合治疗,治疗12周后比较3组患者治疗前后的血流动力学、6min步行距离、WHO肺动脉高压功能分级、Borg呼吸困难评分、血浆脑钠肽、血尿酸以及动脉血氧分压的变化。结果:3组患者经治疗后肺动脉收缩压、肺动脉平均压、全肺血管阻力均下降,6min步行距离增加,WHO肺动脉高压功能分级提高,Borg呼吸困难评分下降,脑钠肽、血尿酸下降,动脉血氧分压升高(P<0.05),联合治疗组疗效明显优于单独用药组(P<0.05),贝前列素钠组和西地那非组疗效差异无明显统计学意义(P>0.05)。3组药物不良反应发生率分别为20.0%、15.4%和25.0%。观察2~3周后症状逐渐消失。联合用药组不良反应发生率略高于其余2组(P<0.05)。结论:贝前列素钠联合西地那非较单独用药更能有效地降低肺动脉压力,改善血流动力学,提高运动耐力,改善临床症状。
Objective: To investigate the efficacy and safety of beraprost sodium and sildenafil in the treatment of pulmonary hypertension. Methods: Forty-four patients (7 males and 37 females, aged 27-69 years) were enrolled in this study. They were randomly divided into beraprost sodium group (n = 15), sildenafil group (n = 13) And combination therapy group (16 cases) were given beraprost sodium, sildenafil alone and the combination therapy of the two. After 12 weeks of treatment, the hemodynamics, 6min walk distance, WHO pulmonary artery High pressure functional classification, Borg dyspnea score, plasma brain natriuretic peptide, serum uric acid and arterial partial pressure of oxygen. Results: After treatment, pulmonary artery systolic pressure, mean pulmonary artery pressure and pulmonary vascular resistance decreased in all three groups, and the walking distance increased in 6 min. The functional grade of pulmonary hypertension increased, Borg dyspnea score decreased, brain natriuretic peptide, serum uric acid decreased, arterial The partial pressure of blood oxygen increased (P <0.05), and the curative effect of the combined treatment group was better than that of the single treatment group (P <0.05), while the difference between the beraprost sodium group and the sildenafil group was not statistically significant (P> 0.05 ). Adverse drug reactions in the three groups were 20.0%, 15.4% and 25.0%, respectively. Observed 2 to 3 weeks after the symptoms gradually disappear. The incidence of adverse reactions in the combination group was slightly higher than the other two groups (P <0.05). Conclusion: Bezaplatin combined with sildenafil is more effective in lowering pulmonary artery pressure, improving hemodynamics, improving exercise endurance and improving clinical symptoms than single drug alone.