前列地尔联合一氧化氮治疗先天性心脏病合并肺动脉高压患儿的临床研究

发布时间：2018-06-19 13:36

本文选题：前列地尔 + 一氧化氮　；参考：《中国药房》2017年17期

【摘要】：目的:观察前列地尔联合一氧化氮对先天性心脏病合并肺动脉高压患儿的临床效果及免疫功能的影响。方法:采用回顾性研究方法,选取2009年8月-2015年2月我院胸心血管外科收治的40例先天性心脏病合并肺动脉高压患儿,依据治疗方式不同分为一氧化氮组(单独组)和前列地尔+一氧化氮组(联合组),各20例。两组患儿均给予先天性心脏病合并肺动脉高压的常规手术治疗;单独组患儿术后予以外源性吸入一氧化氮(体积分数为20×10-6),联合组患儿在此基础上联合静脉泵入前列地尔5 ng/(kg·min),持续72 h。比较两组患儿治疗前后的心率、左室射血分数、平均动脉压、肺动脉压、T淋巴细胞和免疫球蛋白(Ig)的变化,以及不良反应发生情况。结果:治疗前,两组患儿上述各项指标比较,差异均无统计学意义(P0.05)。治疗后,两组患儿的心率、左室射血分数、平均动脉压、CD3~+、Ig A、Ig M和Ig G水平无明显变化,但CD4~+、CD4~+/CD8~+、Treg/CD4~+均较治疗前显著升高,肺动脉压、CD8~+、Th1、Th2、Th1/Th2、Th17/CD4~+、补体C3和补体C4水平均较治疗前显著下降,且联合组上述指标均显著优于单独组,差异均有统计学意义(P0.05)。两组患儿均未见明显不良反应发生。结论:前列地尔联合一氧化氮可显著降低先天性心脏病合并肺动脉高压患儿的肺动脉压,改善T淋巴细胞表达情况,降低补体C3和C4水平,且安全性较高。
[Abstract]:Aim: to observe the clinical effect and immune function of prostadil combined with nitric oxide in children with congenital heart disease complicated with pulmonary hypertension. Methods: a retrospective study was conducted on 40 children with congenital heart disease complicated with pulmonary hypertension from August 2009 to February 2015. The patients were divided into two groups: nitric oxide group (20 cases) and prostadil nitric oxide group (20 cases). Children in both groups were treated with conventional surgical treatment of congenital heart disease complicated with pulmonary hypertension. Children in the single group were given exogenous inhaled nitric oxide (volume fraction 20 脳 10 ~ (-6) after operation, and combined with intravenous infusion of alprostadil for 72 hours. The changes of heart rate, left ventricular ejection fraction, mean arterial pressure, pulmonary artery pressure T lymphocyte and immunoglobulin IgA before and after treatment were compared between the two groups. Results: before treatment, there was no significant difference in the above indexes between the two groups (P 0.05). After treatment, the heart rate, left ventricular ejection fraction (LVEF), mean arterial pressure (CD3 ~ +), Ig Ag M and IgG levels in both groups were not significantly changed, but CD4 ~ + / CD4 ~ / CD8 ~ / CD8 ~ + Treg-CD4 ~ were significantly higher than those before treatment, and pulmonary artery pressure was significantly higher than that before treatment, and the pulmonary artery pressure (PPA) was CD8 ~ + Th1Th2Th2Th2Th1 / Th2Th17 / CD4 ~. The levels of complement C3 and complement C4 were significantly lower than those before treatment, and the above indexes in the combined group were significantly better than those in the single group, and the differences were statistically significant (P 0.05). No significant adverse reactions occurred in both groups. Conclusion: prostadil combined with nitric oxide can significantly reduce pulmonary artery pressure, improve the expression of T lymphocytes and decrease the levels of C3 and C4 in children with congenital heart disease complicated with pulmonary hypertension.
【作者单位】：右江民族医学院附属医院胸心血管外科;
【基金】：国家自然科学基金资助项目(No.81560076)
【分类号】：R725.4

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