中国医疗前沿
中國醫療前沿
중국의료전연
CHINA HEALTHCARE INNOVATION
2013年
17期
3-4
,共2页
室间隔缺损%难治性肺动脉高压%法舒地尔
室間隔缺損%難治性肺動脈高壓%法舒地爾
실간격결손%난치성폐동맥고압%법서지이
Ventricular sepal defect%Refractory pulmonary arterial hypertension%Fasudil
目的：明确长期应用法舒地尔雾化吸入对室间隔缺损术后持续难治性肺动脉高压的治疗作用。方法选择室间隔缺损术后常规治疗6个月仍然持续中度以上肺动脉高压的患者，按照年龄和性别匹配随机分为两组，除常规治疗外，治疗组给予法舒地尔100mg雾化吸入，2次/d，持续12个月，对照组给予同等剂量生理盐水雾化吸入。治疗后3、6、12个月行多普勒超声心动图仪测量肺动脉收缩压(PASP)、左心室射血分数(LVEF)、右心室射血分数(RVEF)和血氧分压(PaO2)。结果与对照组相比，治疗组PASP第6个月时明显降低(P<0.01)，第12个月继续降低(P<0.01)；LVEF6个月时显著升高，至第12个月时仍然持续升高；RVEF第3个月时即明显升高(P<0.05)，至第6、12个月时仍持续升高(P<0.01)；PaO2第6个月时升高(P<0.05)，第12个月时仍持续升高(P<0.05)。对照组3年生存率为87.5%，5年生存率为62.5%，治疗组5年生存率为100%。结论长期法舒地尔雾化吸入，能显著降低室间隔手术后持续难治性肺动脉高压患者肺动脉收缩压，提升心功能，降低死亡率。
目的：明確長期應用法舒地爾霧化吸入對室間隔缺損術後持續難治性肺動脈高壓的治療作用。方法選擇室間隔缺損術後常規治療6箇月仍然持續中度以上肺動脈高壓的患者，按照年齡和性彆匹配隨機分為兩組，除常規治療外，治療組給予法舒地爾100mg霧化吸入，2次/d，持續12箇月，對照組給予同等劑量生理鹽水霧化吸入。治療後3、6、12箇月行多普勒超聲心動圖儀測量肺動脈收縮壓(PASP)、左心室射血分數(LVEF)、右心室射血分數(RVEF)和血氧分壓(PaO2)。結果與對照組相比，治療組PASP第6箇月時明顯降低(P<0.01)，第12箇月繼續降低(P<0.01)；LVEF6箇月時顯著升高，至第12箇月時仍然持續升高；RVEF第3箇月時即明顯升高(P<0.05)，至第6、12箇月時仍持續升高(P<0.01)；PaO2第6箇月時升高(P<0.05)，第12箇月時仍持續升高(P<0.05)。對照組3年生存率為87.5%，5年生存率為62.5%，治療組5年生存率為100%。結論長期法舒地爾霧化吸入，能顯著降低室間隔手術後持續難治性肺動脈高壓患者肺動脈收縮壓，提升心功能，降低死亡率。
목적：명학장기응용법서지이무화흡입대실간격결손술후지속난치성폐동맥고압적치료작용。방법선택실간격결손술후상규치료6개월잉연지속중도이상폐동맥고압적환자，안조년령화성별필배수궤분위량조，제상규치료외，치료조급여법서지이100mg무화흡입，2차/d，지속12개월，대조조급여동등제량생리염수무화흡입。치료후3、6、12개월행다보륵초성심동도의측량폐동맥수축압(PASP)、좌심실사혈분수(LVEF)、우심실사혈분수(RVEF)화혈양분압(PaO2)。결과여대조조상비，치료조PASP제6개월시명현강저(P<0.01)，제12개월계속강저(P<0.01)；LVEF6개월시현저승고，지제12개월시잉연지속승고；RVEF제3개월시즉명현승고(P<0.05)，지제6、12개월시잉지속승고(P<0.01)；PaO2제6개월시승고(P<0.05)，제12개월시잉지속승고(P<0.05)。대조조3년생존솔위87.5%，5년생존솔위62.5%，치료조5년생존솔위100%。결론장기법서지이무화흡입，능현저강저실간격수술후지속난치성폐동맥고압환자폐동맥수축압，제승심공능，강저사망솔。
Objective The effects of fasudil on refractory pulmonary arterial hypertension after surgery for ventricular septal defect. Objective To evaluate the therapeutic effects of fasudil on refractory pulmonary arterial hypertension(PAH) after surgery for ventricular septal defect. Methods Seventeen ventricular septal defect patients with postoperational refractory PAH after surgery for ventricular septal defect were randomly divided into control group (n=9, 2 months of normal saline inhalation plus conventional therapy) and treatment group (n=8, 12 months of fasudil inhalation plus conventional therapy). The PASP, RVEF, and LVEF were measured by echocardiography before and 3, 6, and 12 months after the treatment. PaO2 was monitored. Results Cumulative survival rate in the control group were 87.5% at 3 years and 62.5% at 5 years, while that in the treatment group was 100% at 5 years. Compared with the control group, PASP of patients in the treatment group decreased significantly at 6 and 12 months after fasudil treatment(P<0.01), LVEF and PaO2 of patients in the treatment group increased significantly at 6 and 12 months(P<0.01); while RVEF of patients in the treatment group showed significant increase at 3 months(P<0.05) and continued to increase at 6 and 12 months(P<0.01). Conclusions Fasudil inhalation therapy after corrective surgery for ventricular septal defect was associated with a reduction in pulmonary arterial systolic pressure,increase of heart function and lower risk of death.
