论文部分内容阅读
目的观察肺动脉高压靶向药物治疗对艾森曼格综合征的临床效果。方法选择艾森曼格综合征患者36例,年龄9~51(39±18)岁。其中房间隔缺损(ASD)11例、室间隔缺损(VSD)14例、动脉导管未闭(PDA)6例、VSD+PDA 3例、ASD+PDA 2例。应用波生坦或西地那非治疗,根据服药情况分为长期用药组和间断用药组,2年后评估其疗效。结果长期用药组2年后经皮血氧饱和度(SpO_2)、6 min步行距离(6MWTD)较用药前显著升高(P<0.05),Borg评分、纽约心脏病学会心功能分级(NYHA)、脑钠尿肽(BNP)、肺动脉收缩压(sPAP)较用药前显著减低(P<0.05)。与用药前相比,肺循环血流量/体循环血流量(Qp/Qs)显著升高(P<0.05),肺动脉平均压(mPAP)、肺动脉收缩压/体循环收缩压(Pp/Ps)显著减低(P<0.05);肺血管阻力(PVR)也有不同程度降低,但差异无统计学意义。间断用药组SpO_2、6MWTD较用药前亦显著升高(P<0.05),BNP较用药前显著减低(P<0.05);Borg评分、NYHA、sPAP虽有不同程度改善,但差异无统计学意义。长期用药组与间断用药组相比,6MWTD、Borg评分、NYHA、BNP、sPAP等指标均无明显差异。但长期用药组SpO_2显著升高(P<0.05)。结论间断靶向治疗可用于部分艾森曼格综合征患者。
Objective To observe the clinical effect of pulmonary arterial hypertension on Eisenmenger’s syndrome. Methods Thirty-six patients with Eisenmenger’s syndrome were selected, aged 9-51 years (39 ± 18 years). There were 11 cases of atrial septal defect (ASD), 14 cases of ventricular septal defect (VSD), 6 cases of patent ductus arteriosus (PDA), 3 cases of VSD + PDA and 2 cases of ASD + PDA. The application of bosentan or sildenafil treatment, according to the medication is divided into long-term medication group and intermittent medication group, 2 years after the assessment of its efficacy. Results After 2 years of treatment, the long-term administration of SpO_2, 6-min walking distance (6MWTD) were significantly higher than those before treatment (P <0.05), Borg scores, New York Heart Association Cardiac Function Classification (NYHA) Brain natriuretic peptide (BNP), pulmonary artery systolic pressure (sPAP) was significantly lower than before treatment (P <0.05). Pulmonary circulation blood flow / systemic blood flow (Qp / Qs) was significantly increased (P <0.05), pulmonary artery mean pressure (mPAP) and pulmonary artery systolic pressure / systemic systolic pressure (Pp / <0.05). Pulmonary vascular resistance (PVR) also decreased to some extent, but the difference was not statistically significant. Intermittent drug group SpO_2, 6MWTD were significantly higher than before treatment (P <0.05), BNP was significantly lower than before treatment (P <0.05); Borg score, NYHA, sPAP although varying degrees of improvement, but the difference was not statistically significant. Long-term medication group and intermittent medication group, 6MWTD, Borg score, NYHA, BNP, sPAP and other indicators were not significantly different. But long-term medication group SpO_2 was significantly higher (P <0.05). Conclusion Intermittent targeted therapy can be used in some patients with Eisenmenger’s syndrome.