西地那非联合波生坦治疗儿童先心病合并肺动脉高压的临床研究
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江苏省妇幼健康和计划生育生殖健康科研项目(F201509)


A clinical study of bosentan and sildenafil in treatment of children with pulmonary artery hypertension and congenital Heart1 disease
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    摘要:

    目的:评估西地那非联合波生坦治疗儿童先天性心脏病(congentinal heart disease,CHD)手术前后合并肺动脉高压(pulmonary arterial hypertension,PAH)的临床疗效及安全性。方法:选取有服药指征的CHD合并PAH患儿共50例,随机分为A组和B组,A组患儿给予西地那非治疗,B组患儿口服西地那非联合波生坦。用药后定期随访,评估两组治疗前后临床效果、药物不良反应及并发症等。结果:A组共30例,男17例,女13例。B组共20例,男8例,女12例。①A、B两组治疗前后心功能均得到明显改善,B组心功能分级改善程度优于A组(P<0.05);②A、B两组治疗后3、6个月心超提示肺动脉压力均较前降低,B组降低更显著(P<0.05);③A、B两组治疗前后检验结果、机械通气时间、监护停留时间及体外循环时间均无明显差别(P>0.05),所有患儿均良好耐受,未出现明显不良反应及并发症。结论:西地那非能够降低儿童CHD手术前后合并PAH的肺动脉压力,而西地那非联合波生坦片治疗儿童CHD 术后PAH 疗效更显著,且具有较好的安全性。

    Abstract:

    Objective:To investigate the clinical efficacy and safety of sidenafil and bosentan in the therapy of children with pulmonary artery hypertension(PAH) and congenital heart disease(CHD). Methods:Fifty cases of PAH combined with CHD were selected and randomly divided into the A group and B group. A group was given sildenafil therapy,and on this basis the B group was added with bosentan tablets. The two groups were followed up periodically to analyze the clinical outcome,adverse reaction and complication.Results:There were 17 cases males and 13 cases females in the A group,and 8 cases males and 12 cases females in the B.①World Health Organization functional class was improved significantly in both after therapy,and the B group was superior to the A;②The PAH after treatment in both groups was improved,moreover the effect in the B group;③There was no significant changes in the assay,Guardianship residence time and the duration of ventilatory support. No severe side effect and complication were observed. Conclusion:The results revealed the efficacy of bosentan in children with PAH and CHD,and bosentan is safety and validity.

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孔祥萦,陆凤霞,周 洁,顾 群,张永生,黄 琼,沈 沉,孟亚玲,金 珉,陈 斌,顾海涛.西地那非联合波生坦治疗儿童先心病合并肺动脉高压的临床研究[J].南京医科大学学报(自然科学版),2017,(7):861-864

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  • 收稿日期:2017-01-07
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  • 在线发布日期: 2017-07-16
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