西地那非联合波生坦治疗儿童先心病合并肺动脉高压的临床研究

发布时间：2018-03-07 14:21

本文选题：先天性心脏病　切入点：肺动脉高压　出处：《南京医科大学学报(自然科学版)》2017年07期 　论文类型：期刊论文

【摘要】：目的 :评估西地那非联合波生坦治疗儿童先天性心脏病(congentinal heart disease,CHD)手术前后合并肺动脉高压(pulmonary arterial hypertension,PAH)的临床疗效及安全性。方法 :选取有服药指征的CHD合并PAH患儿共50例,随机分为A组和B组,A组患儿给予西地那非治疗,B组患儿口服西地那非联合波生坦。用药后定期随访,评估两组治疗前后临床效果、药物不良反应及并发症等。结果:A组共30例,男17例,女13例。B组共20例,男8例,女12例。(1)A、B两组治疗前后心功能均得到明显改善,B组心功能分级改善程度优于A组(P0.05);(2)A、B两组治疗后3、6个月心超提示肺动脉压力均较前降低,B组降低更显著(P0.05);(3)A、B两组治疗前后检验结果、机械通气时间、监护停留时间及体外循环时间均无明显差别(P0.05),所有患儿均良好耐受,未出现明显不良反应及并发症。结论:西地那非能够降低儿童CHD手术前后合并PAH的肺动脉压力,而西地那非联合波生坦片治疗儿童CHD术后PAH疗效更显著,且具有较好的安全性。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of sildenafil combined with Bosentam in the treatment of children with pulmonary arterial hypertensionsion before and after operation for congenital heart disease. Methods: 50 children with CHD and PAH were selected. Children in group A and group B were randomly divided into two groups: group A and group A were treated with sildenafil and group B were treated with sildenafil combined with Bosentan. Results there were 30 cases in group A, 17 cases in male, 20 cases in group B, 8 cases in male. After treatment, the cardiac function of group B was significantly improved than that of group A (P 0.05) and group A (P 0.05). 6 months of cardiac ultrasound showed that pulmonary artery pressure in group B was significantly lower than that in group B before and after treatment, and the results of examination before and after treatment in group B were significantly higher than those in group B, and the improvement of cardiac function grade in group B was significantly higher than that in group B before and after treatment, the results showed that the pulmonary artery pressure in group B was significantly lower than that in group B before and after treatment. There was no significant difference in mechanical ventilation time, monitoring stay time and cardiopulmonary bypass time. All the children were well tolerated. Conclusion: sildenafil can reduce pulmonary artery pressure associated with PAH before and after CHD operation in children, and sildenafil combined with Bosentan film is more effective and safe in the treatment of PAH after CHD in children.
【作者单位】：南京医科大学第一附属医院小儿胸心外科;
【基金】：江苏省妇幼健康和计划生育生殖健康科研项目(F201509)
【分类号】：R725.4

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