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目的 观察依前列醇长期治疗原发性肺动脉高压 (PPH)的疗效。方法 临床诊断为PPH且心功能为Ⅲ～Ⅳ级的慢性充血性心力衰竭患者 69例 ,均接受依前列醇长期静脉连续注入治疗(起始剂量在 2～ 62ng·kg- 1 ·min- 1 范围内。在长期治疗中 ,药物剂量应根据患者的反应进行调整 ,剂量通常随治疗时间每 2个月增加 1次 ,每次增加 1～ 2ng·kg- 1 ·min- 1 )并观察其疗效。用右心导管法和超声心动图检查法对所有患者测量三尖瓣跨瓣压 (ΔP)和心输出量 (CO)。随访期间每 4个月用超声心动图检查法复查上述指标 1次。结果 PPH患者长期用依前列醇治疗后 ,ΔP由 (84 1± 2 4 1 )mmHg (1mmHg=0 1 33kPa)降至 (62 7± 1 8 2 )mmHg(P <0 0 1 ) ,CO由 (4 0 0± 1 2 2 )L/min升至 (4 70± 1 2 7)L/min(P <0 0 2 ) ,ΔP/CO由 2 2 8± 9 4降至 1 4 9± 6 5(P <0 0 1 )。结论 长期静脉连续注入依前列醇治疗PPH ,可使患者右室压力逐渐下降 ,CO增加 ,并可明显延长患者的生命
Objective To observe the long-term treatment of eporatan with primary pulmonary hypertension (PPH). Methods Sixty-nine patients with chronic congestive heart failure whose clinical diagnosis was PPH and whose heart function was grade Ⅲ-Ⅳ were treated with long-term continuous infusion of prostaglandin (the initial dosage was in the range of 2 ~ 62ng · kg-1 · min-1 In the long-term treatment, the dose of the drug should be adjusted according to the patient’s response. The dose usually increases by 1 ~ 2ng · kg-1 · min-1 every 2 months with the time of treatment and the effect is observed. Tricuspid transvalvular pressure (ΔP) and cardiac output (CO) were measured in all patients by right heart catheterization and echocardiography. During the follow-up every 4 months with echocardiography to review the above indicators 1 time. Results After prolonged use of epoprostenol in PPH patients, ΔP decreased from (84 1 ± 2 4 1) mmHg (1mmHg = 0 1 33kPa) to (62 7 ± 1 8 2) mmHg (P 0 01) ΔP / CO decreased from 22 8 ± 9 4 to 1 49 ± 6 (P <0 0 2) with the increase of (4 0 0 ± 1 2 2) L / min to (4 70 ± 1 2 7) L / min 5 (P <0 0 1). Conclusion Long-term intravenous infusion of epoprostenol for PPH can decrease the right ventricular pressure, increase the CO, and prolong the life of patients