心血管康复医学杂志
心血管康複醫學雜誌
심혈관강복의학잡지
JOURNAL OF CARDIOVASCULAR REHABILITATION MEDICINE
2015年
3期
288-292
,共5页
刘洋%张刚成%卢蓉%余莹
劉洋%張剛成%盧蓉%餘瑩
류양%장강성%로용%여형
Eisenmenger复合征%高血压 ,肺性%安立生坦
Eisenmenger複閤徵%高血壓 ,肺性%安立生坦
Eisenmenger복합정%고혈압 ,폐성%안립생탄
Eisenmenger complex%Hypertension,pulmonary%Ambrisentan
目的:观察安立生坦治疗艾森曼格综合征(ES)的临床疗效。方法:2011年4月~2014年3月在武汉亚洲心脏病医院住院ES患者79例,分为安立生坦组(38例,地高辛+安立生坦治疗)及常规治疗组(41例,地高辛治疗),治疗12周。观察两组病例在治疗前及治疗12周后6min步行距离(6MWD)、WHO肺动脉高压心功能分级(WHO FC)等。同时观察安立生坦组治疗前后血流动力学参数[包括平均肺动脉压(mPAP)、全肺阻力(TPR)、肺/体循环流量比(Qp/Qs)]的变化。结果:与治疗前比较,12周后安立生坦组患者6MWD明显增加, TPR明显下降, Qp/Qs明显升高, WHO FC心功能分级明显好转( P<0.05或<0.01)。与常规治疗组比较,12周后安立生坦组6MWD [(356.8±74.1) m比(393.7±69.2) m]明显增加、BNP水平[(832.5±422.2) ng/L比(646.6±297.1) ng/L]明显降低、WHO FC心功能分级(I/II级,67.5%比86.8%)明显改善(P<0.05或<0.01),安立生坦组无死亡病例,不良反应轻微,常规治疗组有1例患者死亡。结论:口服安立生坦可以显著改善艾森曼格综合征患者心功能及运动能力,安全性和耐受性良好。
目的:觀察安立生坦治療艾森曼格綜閤徵(ES)的臨床療效。方法:2011年4月~2014年3月在武漢亞洲心髒病醫院住院ES患者79例,分為安立生坦組(38例,地高辛+安立生坦治療)及常規治療組(41例,地高辛治療),治療12週。觀察兩組病例在治療前及治療12週後6min步行距離(6MWD)、WHO肺動脈高壓心功能分級(WHO FC)等。同時觀察安立生坦組治療前後血流動力學參數[包括平均肺動脈壓(mPAP)、全肺阻力(TPR)、肺/體循環流量比(Qp/Qs)]的變化。結果:與治療前比較,12週後安立生坦組患者6MWD明顯增加, TPR明顯下降, Qp/Qs明顯升高, WHO FC心功能分級明顯好轉( P<0.05或<0.01)。與常規治療組比較,12週後安立生坦組6MWD [(356.8±74.1) m比(393.7±69.2) m]明顯增加、BNP水平[(832.5±422.2) ng/L比(646.6±297.1) ng/L]明顯降低、WHO FC心功能分級(I/II級,67.5%比86.8%)明顯改善(P<0.05或<0.01),安立生坦組無死亡病例,不良反應輕微,常規治療組有1例患者死亡。結論:口服安立生坦可以顯著改善艾森曼格綜閤徵患者心功能及運動能力,安全性和耐受性良好。
목적:관찰안립생탄치료애삼만격종합정(ES)적림상료효。방법:2011년4월~2014년3월재무한아주심장병의원주원ES환자79례,분위안립생탄조(38례,지고신+안립생탄치료)급상규치료조(41례,지고신치료),치료12주。관찰량조병례재치료전급치료12주후6min보행거리(6MWD)、WHO폐동맥고압심공능분급(WHO FC)등。동시관찰안립생탄조치료전후혈류동역학삼수[포괄평균폐동맥압(mPAP)、전폐조력(TPR)、폐/체순배류량비(Qp/Qs)]적변화。결과:여치료전비교,12주후안립생탄조환자6MWD명현증가, TPR명현하강, Qp/Qs명현승고, WHO FC심공능분급명현호전( P<0.05혹<0.01)。여상규치료조비교,12주후안립생탄조6MWD [(356.8±74.1) m비(393.7±69.2) m]명현증가、BNP수평[(832.5±422.2) ng/L비(646.6±297.1) ng/L]명현강저、WHO FC심공능분급(I/II급,67.5%비86.8%)명현개선(P<0.05혹<0.01),안립생탄조무사망병례,불량반응경미,상규치료조유1례환자사망。결론:구복안립생탄가이현저개선애삼만격종합정환자심공능급운동능력,안전성화내수성량호。
Objective:To observe therapeutic effect of ambrisentan on Eisenmenger syndrome (ES) .Methods:A total of 79 ES patients ,who hospitalized in Wuhan Asia Heart Hospital from Apr 2011 to Mar 2014 ,were divided into ambrisentan group (n=38 ,received digoxin combined ambrisentan treatment) and routine treatment group (n=41 , received digoxin treatment) ,and both groups were treated for 12 weeks .The 6min walking distance (6MWD) , WHO functional class (WHO FC) of pulmonary hypertension etc .were observed in both groups before and 12-week after treatment .Changes of hemodynamic parameters ,including mean pulmonary artery pressure (mPAP) ,total pulmonary resistance (TPR) and ratio of pulmonary circulating flow to system circulating flow (Qp/Qs) etc .,were observed in ambrisentan group before and after treatment . Results:Compared with before treatment , after 12 weeks ,6MWD significantly rose ,TPR significantly reduced ,Qp/Qs significantly increased and WHO FC signifi-cantly improved in ambrisentan group ,P<0.05 or <0.01. Compared with routine treatment group after 12 weeks , there was significant rise in 6MWD [ (356.8 ± 74.1) m vs .(393.7 ± 69.2) m] ,significant reduction in BNP level [(832.5 ± 422.2) ng/L vs .(646.6 ± 297.1) ng/L] and significant improvement in WHO FC (class I/II ,67.5% vs . 86.8% ) in ambrisentan group ,P<0.05 or <0.01. No patient died ,the adverse reactions were mild in ambrisentan group ;one case died in routine treatment group .Conclusion:Oral ambrisentan can significantly improve heart func-tion and exercise capacity in patients with Eisenmenger syndrome ,and it possesses good safety and tolerance .