中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2011年
6期
419-423
,共5页
卢献灵%熊长明%单广良%柳志红%倪新海%程显声%顾晴%赵智慧%曾伟杰%朱锋%何建国
盧獻靈%熊長明%單廣良%柳誌紅%倪新海%程顯聲%顧晴%趙智慧%曾偉傑%硃鋒%何建國
로헌령%웅장명%단엄량%류지홍%예신해%정현성%고청%조지혜%증위걸%주봉%하건국
高血压肺性,运动耐量%血液循环%西地那非
高血壓肺性,運動耐量%血液循環%西地那非
고혈압폐성,운동내량%혈액순배%서지나비
Hypertension,pulmonary%Exercise tolerance%Blood circulation%Sildenafil
目的 探讨西地那非治疗对肺动脉高压患者的临床疗效及耐受性,为西地那非治疗肺动脉高压提供依据.方法 连续入选2007年5月至2009年4月阜外心血管病医院收治的肺动脉高压患者56例,其中男11例,女45例,年龄(31±11)岁.给予西地那非25 mg口服,3次/d,记录治疗前和治疗12周后患者心功能和肺动脉高压功能分级、6 min步行距离、Borg呼吸困难指数、血流动力学改变及临床症状,同时监测患者血液循环及实验室检测指标及不良反应.结果 治疗12周后,患者心功能和肺动脉高压功能分级有明显改善(P<0.01),其中2例Ⅳ级升高至Ⅲ级;8例Ⅲ级改善为Ⅱ级,2例升高至Ⅰ级;5例Ⅱ级升高至Ⅰ级.无纽约心功能分级及世界卫生组织肺动脉高压功能分级恶化病例;6 min步行距离由(352±80)m增加至(396±78)m;差值为(44±70)m(P<0.01);肺动脉平均压降低(6±14)mm Hg(1 mm Hg=0.133 kPa)、肺血管阻力降低(490±832) Dys·s·cm-5(均P<0.01)心输出量增加(1.1±2.0) L/min,P<0.01;心指数增加(0.7±1.1) L·min-1·m-2(均P<0.01).患者无临床恶化情况,耐受性良好,无严重不良事件.结论 西地那非治疗可显著改善肺动脉高压患者功能分级,活动耐力及血流动力学.
目的 探討西地那非治療對肺動脈高壓患者的臨床療效及耐受性,為西地那非治療肺動脈高壓提供依據.方法 連續入選2007年5月至2009年4月阜外心血管病醫院收治的肺動脈高壓患者56例,其中男11例,女45例,年齡(31±11)歲.給予西地那非25 mg口服,3次/d,記錄治療前和治療12週後患者心功能和肺動脈高壓功能分級、6 min步行距離、Borg呼吸睏難指數、血流動力學改變及臨床癥狀,同時鑑測患者血液循環及實驗室檢測指標及不良反應.結果 治療12週後,患者心功能和肺動脈高壓功能分級有明顯改善(P<0.01),其中2例Ⅳ級升高至Ⅲ級;8例Ⅲ級改善為Ⅱ級,2例升高至Ⅰ級;5例Ⅱ級升高至Ⅰ級.無紐約心功能分級及世界衛生組織肺動脈高壓功能分級噁化病例;6 min步行距離由(352±80)m增加至(396±78)m;差值為(44±70)m(P<0.01);肺動脈平均壓降低(6±14)mm Hg(1 mm Hg=0.133 kPa)、肺血管阻力降低(490±832) Dys·s·cm-5(均P<0.01)心輸齣量增加(1.1±2.0) L/min,P<0.01;心指數增加(0.7±1.1) L·min-1·m-2(均P<0.01).患者無臨床噁化情況,耐受性良好,無嚴重不良事件.結論 西地那非治療可顯著改善肺動脈高壓患者功能分級,活動耐力及血流動力學.
목적 탐토서지나비치료대폐동맥고압환자적림상료효급내수성,위서지나비치료폐동맥고압제공의거.방법 련속입선2007년5월지2009년4월부외심혈관병의원수치적폐동맥고압환자56례,기중남11례,녀45례,년령(31±11)세.급여서지나비25 mg구복,3차/d,기록치료전화치료12주후환자심공능화폐동맥고압공능분급、6 min보행거리、Borg호흡곤난지수、혈류동역학개변급림상증상,동시감측환자혈액순배급실험실검측지표급불량반응.결과 치료12주후,환자심공능화폐동맥고압공능분급유명현개선(P<0.01),기중2례Ⅳ급승고지Ⅲ급;8례Ⅲ급개선위Ⅱ급,2례승고지Ⅰ급;5례Ⅱ급승고지Ⅰ급.무뉴약심공능분급급세계위생조직폐동맥고압공능분급악화병례;6 min보행거리유(352±80)m증가지(396±78)m;차치위(44±70)m(P<0.01);폐동맥평균압강저(6±14)mm Hg(1 mm Hg=0.133 kPa)、폐혈관조력강저(490±832) Dys·s·cm-5(균P<0.01)심수출량증가(1.1±2.0) L/min,P<0.01;심지수증가(0.7±1.1) L·min-1·m-2(균P<0.01).환자무림상악화정황,내수성량호,무엄중불량사건.결론 서지나비치료가현저개선폐동맥고압환자공능분급,활동내력급혈류동역학.
Objective To explore the safety and efficacy of oral sildenafil therapy for pulmonary arterial hypertension(PAH), and to provide evidence for sildenafil treatment for Chinese patients with PAH. Methods In this 12-week, prospective, open-label, uncontrolled study, 56 patients with PAH were given oral sildenafil (25 mg, tid). The primary end point was change from baseline to 12 weeks in exercise capacity assessed by 6 min walk (6MW) test. Secondary end points included changes in WHO class and cardiopulmonary hemodynamics. Clinical worsening was defined as death, transplantation, hospitalization for PAH, or initiation of additional therapies for PAH, such as intravenous epoprostenol or oral bosentan. Results After 12 weeks, the compliance was good in 56 patients. Significant improvement was seen in NYHA heart function class and WHO class as compared to baseline(P<0.01): from class Ⅳ to class Ⅲ in 2, from class Ⅲ to class Ⅱ in 8 and to class Ⅰ in 2 cases, and from class Ⅱ to class Ⅰ in 5 cases. No NYHA heart function class and WHO PAH function class deterioration were observed. Oral sidenafil increased 6MW distance, from (352±80) m to (396±78) m, with a change of (44±70) m(P<0.01). Significant improvement was seen in hemodynamics (mean pulmonary artery pressure, P<0.01; cardiac index, P<0.01; pulmonary vascular resistance, P<0.01) at week 12 as compared with baseline. Mean right atrial pressure decreased (3±11)mm Hg (1 mm Hg=0.133 kPa), mean pulmonary arterial pressure decreased (6±14) mm Hg, cardiac output increased (1.1±2.0)L/min, cardiac index increased (0.7±1.1)L·min-1·m-2, and total pulmonary resistance decreased (490±831) Dys·s·cm-5. Side effects were mild and consistent with those reported with sildenafil treatment. No statistically significant clinical worsening was observed with sildenafil therapy for PAH patients. Conclusions Sildenafil improves exercise capacity, WHO functional class, and hemodynamics in patients with pulmonary arterial hypertension.
