口服伐地那非治疗肺动脉高压的临床观察

目的：观察口服伐地那非对肺动脉高压患者的临床疗效及其量效关系。方法：采用前瞻性、开放性、随机对照研究方法，入选的48例肺动脉高压患者被均分为5mg治疗组、10mg治疗组及20mg治疗组，疗程6个月，观察患者治疗前后6min步行距离（6MWD）、WHO肺动脉高压功能分级和血流动力学指标的变化，以及药物的安全性。结果：口服不同剂量伐地那非6月后，各组患者6MwD显著增加，WHO肺动脉高压功能分级改善，活动耐量增加，肺动脉收缩压（PASP）明显下降（P均〈0．05）；与5mg治疗组比较，10mg和20mg治疗组治疗后的6MWD增量[（46．9±14．7）m比（80．8±17．2）m、（81．9±19．6）m]和PASP减少量[（14．1±3．6）mmHg比（26．4±4．5）mmHg、（27．8±5．7）mmHg]均显著增加（P〈0．05），10mg与20mg治疗组相比，其6MWD增量和减少量、PASP差异无显著性；但治疗后三组的6MWD、PASP值无显著差异。口服伐地那非不良反应小，耐受性好。结论：口服伐地那非可以降低肺动脉收缩压，提高肺动脉高压患者的活动耐量，并呈一定程度的量效关系。

Clinical observation of curative effect of oral vardenafii on pulmonary arterial hypertension

Objective： To observe clinical curative effect of oral vardenafil on patients with pulmonary arterial hyper-tension （PAH） and its dose-effect relationship. Methods： In this prospective, open-label, randomized controlled study, a total of 48 PAH patients were randomly and equally divided into 5 mg, 10 mg and 20 mg treatment group, therapeutic course was six months. Changes of 6min walking distance （6MWD）, WHO PHA function class and he-modynamic indexes before and after treatment, and drug safety were observed. Results： After taking different doses of vardenafil oral for six months, there were significant increase in 6MWD, significant improvement in WHO PHA function class and significant decrease in pulmonary artery systolic pressure （PASP）, P〈0.05 all; compared with 5 mg treatment group, there were significant increase in increment of 6MWD [ （46.9 ± 14.7） m vs. （80.8 ± 17.2） m, （81.9±19.6） m] and decrement of PASP[ （14.1±3.6） mmHgvs. （26.4±4.5） mmHg, （27.8±5.7） mm-Hg] in 10 mg and 20 mg treatment group, P〈0.05 all, those were no significant difference between 10 mg and 20 mg treatment group. The 6MWD and PASP values after treatment were no significant difference among three groups （P〉0. 05）. Oral vardenafil possessed few reverse reactions and good tolerance. Conclusion： Oral vardenafil thera-py can improve exercise tolerance and decrease pulmonary artery systolic pressure in patients with pulmonary arterial hypertension.