前列地尔在先天性心脏病合并重度肺动脉高压患儿治疗中的作用

目的探讨先天性心脏病(CHD)合并重度肺动脉高压(PH)术前应用前列地尔的意义。方法 56例CHD合并PH的患儿,术前予前列地尔100μg加入氯化钠注射液100mL中静脉微量泵泵入,0.02～0.05μg·kg~(-1)·min~(-1),每日持续用药8～10h,连续用药14～18d。对比分析用药前后的平均肺动脉压(mPAP)、平均体动脉压(mSAP)、周围动脉血氧分压(PaO_2)、血氧饱和度(SaO_2)和左心室射血分数(LVEF),并观察患儿不良反应情况。结果前列地尔治疗后,CHD合并重度PH患儿mPAP显著降低(P<0.01),而LVEF、SaO_2及PaO_2均不同程度提高(P<0.05),无严重不良反应发生。结论术前用前列地尔治疗后可明显改善CHD合并重度PH患儿的心、肺功能,提高手术的安全性。

Clinical effects of alprostadil for children with congenital heart disease associated with severe pulmonary hypertension

AIM To evaluate the effects of alprostadil on children with congenital heart disease(CHD) associated with pulmonary hypertension(PH).METHODS Fifty-six patients with CHD associated with PH underwent open heart surgery under cardiopulmonary bypass.All patients received alprostadt 100μg at 0.02- 0.05μg·kg~(-1)·min~(-1) daily for 14-18 d before surgery.The mean pulmonary artery pressured(mPAP),mean systemic artery pressure(mSAP),arterial partial pressure of oxygen(PaO_2) and left ventricular ejection fraction(LVEF) were analyzed before and after alprostadil therapy.Postoperative condition and adverse reactions were observed.RESULTS After alprostadil treatment,mPAP was significantly reduced(P<0.01), PaO_2,LVEF and SaO_2 were significantly increased(P<0.05).There were no serious adverse reactions. CONCLUSION Preoperative treatment with alprostadil can improve heart and lung function of children with CHD associated with PH.