前列腺素E1治疗肺动脉高压的量-效关系

目的观察经肺动脉应用前列腺素E1(PGE1)的剂量与肺动脉压下降程度的量-效关系,探索应用PGE1的最佳剂量.方法将32例室间隔缺损(VSD)并肺动脉高压的病人随机分为4组,分别经肺动脉应用PEG120、40、60、80ng/(kg.min),观察肺动脉平均压(MPAP)的下降情况及体动脉平均压(MSAP)和心指数(CI)的变化.结果 PGE1的剂量在20-60ng/(kg.min)时,MPAP的下降程度与PGE1剂量呈正相关,而60ng/(kgmin)组与80ng/(kg.min)组MPAP的下降程度无明显差异(P＞0.05);PGE1的剂量与MSAP的下降程度呈正相关;各剂量PGE1均能使CI升高,但各剂量间无差异(P＞0.05).结论PGE1 40-60ng/(kg.min)可有效降MPAP又不引起严重的MSAP下降,是应用PGE1治疗肺动脉高压的较理想剂量.

The Dose-Effect Relation of ProstaglandinE1 to Treat Pulmonary Hypertension

Objective To observe te dose-effect relation between the dose of prostaglandinE1 and the decline degree of pulmonary hypertension ,so as to explore the optimal dose to treat pulmonary hypertension .Method 32 patients with ventricular septal defect(VSD) complicated by pulmonary hypertension were divided into 4 groups randomly.PGE1 20,40,60,80 ng/(kg.min) were infused respectively.The decline of MPAP and the change of MSAP and CI were observed .Result The dose from 20 to 60 g/(kg .min) of PGE1 had positive correlation with the decline of MPAP ,but the effect had no difference between 60 ng/(kg.min) and 80 ng/(kg.min) (P>0.05). The dose of PGE1 had positive correlation with the decline of MSAP and all the doses of PGE1 cuold increase CI.Conclusion PGE1 40-60ng/(kg.min) can decrease MPAP efficiently and only decrease MSAP longitudinally,and can improve heart function ,so it is ideal dose to treat pulmonary hypertension.