重组人脑利钠肽治疗二尖瓣病变术后肺动脉高压的疗效观察
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江苏高校优势学科建设工程资助(JX10231801)


Effects of recombinant human brain natriuretic peptide on patients with pulmonary hypertension after mitral valve surgery
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    摘要:

    目的:评估重组人脑利钠肽治疗二尖瓣病变术后肺动脉高压的临床效果-方法:48例二尖瓣置换或成形术后伴肺动脉高压的患者,随机分为治疗组(A组,25例)与对照组(B组,23例)-A组术后在常规治疗基础上予重组人脑利钠肽治疗,B组为常规治疗组-分别于术后用药前(T1)以及用药1 h(T2)-3 h(T3)-6 h(T4)和12 h(T5)动态观察两组患者体-肺循环血流动力学的变化情况,检测比较治疗前后血液环磷酸鸟苷 (cyclic guanosine monophosphate,cGMP) 和血栓素A2 (thromboxane A2,TXA2)的变化-结果:A组T3-T4和T5时点的平均肺动脉压(mean pulmonary arterial pressure,MPAP)和肺动脉楔压(pulmonary capillary wedge pressure,PCWP)较T1明显下降(P < 0.05),A组用药后各时点肺血管阻力指数(pulmonary vascular resistance index,PVRI)均较T1明显下降(P < 0.05)-与B组比较,A组T3-T4和T5时点的MPAP和PCWP明显下降 (P < 0.05);与B组比较,A组用药后各时点的PVRI均明显下降(P < 0.05)-A组术后cGMP水平较用药前明显升高,与B组比较亦明显升高(P < 0.05);而TXA2水平则无明显变化-结论:重组人脑利钠肽可通过提高循环cGMP水平有效治疗二尖瓣病变术后的肺动脉高压-

    Abstract:

    Objective:To explore the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) on patients with pulmonary hypertension after mitral valve surgery. Methods:Forty eight patients with postoperative pulmonary hypertension after mitral valve surgery were randomly divided into rhBNP infusion group (group A,n=25) and control group(group B,n=23). Group A received recombinant human brain natriuretic peptide (rhBNP) after treatment,while group B did not. The hemodynamic data were monitored consecutively,and the levels of cyclic guanosine monophosphate (cGMP) and thromboxane A2 (TXA2) were detected pretreatment and after treatment. Results:The mean pulmonary arterial pressure and pulmonary capillary wedge pressure in group A decreased significantly 3 hours,6 hours,and 12 hours,respectively,after treatment,compared to group B (P < 0.05). Pulmonary vascular resistance index in group A decreased significantly 1 hour after treatment,compared to group B (P < 0.05). cGMP in group A increased significantly after the treatment,compared to group B (P < 0.05). TXA2 showed no significant difference within groups and between groups. Conclusion:rhBNP can effectively reduce pulmonary hypertension via increasing serum cGMP level.

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李 芝,王 俊,赵 胜,何志诚,戚晓通,黄陈军,秦建伟.重组人脑利钠肽治疗二尖瓣病变术后肺动脉高压的疗效观察[J].南京医科大学学报(自然科学版),2014,(11):1527-1530

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  • 收稿日期:2014-05-21
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  • 在线发布日期: 2014-11-21
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