西地那非治疗婴幼儿先天性心脏病重度肺动脉高压 .docVIP

西地那非治疗婴幼儿先天性心脏病重度肺动脉高压疗效观察 杨 望，廖 伟，赵聪敏 （400037 重庆第三军医大学新桥医院科ng/（kg·min）,6～8 h/d]。2组均用药7～10 d，比较用药前后肺动脉收缩压（PSAP）、血压（BP）、动脉氧分压[p（O2）]、血氧饱和度 SaO2 等指标的变化。结果 西地那非组患儿治疗7～10 d后肺动脉压降低[（74.6±9.8）mmHg vs（58.3±7.7）mmHg，P 0.05]、动脉氧分压升高[（76.6±7.6）mmHg vs（88.3±5.8）mmHg，P 0.05]、血氧饱和度增加[ 89.3±2.4 % vs （94.6±3.4）%，P 0.05]，而对体循环血压无明显影响[ 92.8±12.3 % vs（93.3±15.6）%，P 0.05]，治疗后西地那非组与治疗前相比肺循环改善，而且治疗效果与对照组无显著性差异。结论 西地那非能有效减轻先天性心脏病合并重度肺动脉高压患儿的肺动脉压力，增加手术矫正心脏畸形的安全性，且给药方便、价格便宜，利于临床推广。 [关键词] 西地那非；先天性心脏病；术前；重度肺动脉高压 [中图法分类号］ [文献标志码] A Therapeutic effect of sildenafil on severe pulmonary arterial hypertension associated with congenital heart disease in infants Yang Wang, Liao Wei, Zhao Congmin Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China [Abstract] Objective To determine the therapeutic effect of sildenafil on severe pulmonary arterial hypertension PAH associated with congenital heart disease in infants. Methods Seventy infants with PAH, 38 males and 32 females, with a mean age of 13.2±2.3 months, and a mean weight of 8.4±1.4kg, hospitalized in our department from January 2009 to November 2010 were enrolled. All the 70 infants were randomly divided into research group n 37 and control group n 33 . There were no significant difference in age, pulmonary artery pressue, p O2 , and SaO2 between the 2 groups. All infants were treated with diuretic digoxin. Those infants in research group were also treated with Sildenafil（0.5 mg/kg4 h and the other of control group were treated with PGE1 [5 ng/ kg·min ]. And the changes of pulmonary artery pressure, arotic blood pressure, SaO2, and p O2 were measured after the drugs were given for 7 to 10 d. Results After using Sildenafil for 7 to 10 d, pulmonary artery pressure was decreased 74.6±9.8 mmHg vs 58.3±7.7 mmHg, P 0.05 , and p O2 was increased significantly （76.6±7.6 mmHg vs 88.3±5.8 mmHg，P 0.05）,SaO2 was elevated（76.6±7.6 mmHg vs 88.3±5.8 mmHg, P 0.05）. There was no significant