西地那非治疗慢性阻塞性肺疾病相关肺动脉高压的疗效

发布时间：2018-06-24 20:52

本文选题：慢性阻塞性肺疾病(COPD) + 肺动脉高压(PH)　；参考：《中国老年学杂志》2015年05期

【摘要】：目的探讨西地那非对慢性阻塞性肺疾病(COPD)相关肺动脉高压(PH)患者的治疗作用及其对血浆一氧化氮(NO)及内皮型一氧化氮合酶(eNOS)水平的影响。方法将56例COPD合并PH住院患者,随机分为常规治疗组(吸氧、抗感染、利尿、强心等常规治疗)和西地那非组(常规治疗+口服枸橼酸西地那非25mg,2次/d),分别观察两组治疗前、治疗4w后肺动脉收缩压(PASP),6 min步行距离,血浆NO及eNOS的变化。结果常规治疗组及西地那非组治疗后PASP均明显低于治疗前,6min步行距离较治疗前明显增加(P0.001);且西地那非组更为明显(P0.05)。常规治疗组及西地那非组治疗后血浆NO和eNOS明显高于治疗前(P0.001)。西地那非组治疗后血浆NO和eNOS明显高于常规治疗组(P0.05)。结论西地那非联合常规治疗比单用常规治疗更有效。西地那非可能通过上调NO含量和eNOS活性来抑制血管重建和血管收缩,降低肺动脉压力,改善运动耐量,从而治疗COPD相关pH。
[Abstract]:Objective to investigate the effects of sildenafil on plasma nitric oxide (no) and endothelial nitric oxide synthase (Enos) in patients with pulmonary hypertension (PH) associated with chronic obstructive pulmonary disease (COPD). Methods Fifty-six patients with COPD complicated with PH were randomly divided into two groups: routine treatment group (oxygen inhalation, anti-infection, diuretic therapy, cardiopretic therapy) and sildenafil group (oral sildenafil citrate 25 mg / d). After 4 weeks of treatment, pulmonary arterial systolic pressure (PASP) 6 min walking distance, plasma no and Enos changes. Results after treatment, PASP in the conventional treatment group and sildenafil group were significantly lower than that before treatment (P0.001), and sildenafil group was more obvious (P0.05). Plasma no and Enos were significantly higher in conventional treatment group and sildenafil group than before treatment (P 0.001). Plasma no and Enos in sildenafil group were significantly higher than those in routine treatment group (P0.05). Conclusion Sildenafil combined with conventional therapy is more effective than conventional therapy alone. Sildenafil may inhibit vascular remodeling and vasoconstriction by upregulating no content and Enos activity, decrease pulmonary artery pressure, improve exercise tolerance, and thus treat COPD related pHs.
【作者单位】：宁夏人民医院呼吸内科;
【基金】：国家自然科学基金项目(No.81160011) 宁夏回族自治区科技攻关项目(宁陕合作)(No.2011ZYH167)
【分类号】：R563.9

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