前列地尔治疗小儿重度高原性肺动脉高压的临床疗效

目的观察小儿高原性重度肺动脉高压(HPAH)患者接受静脉注射前列地尔治疗的临床疗效。方法 33例重度HPAH患者接受静脉注射前列地尔,用量5～7ng/(kg.h)持续静脉注射,治疗时间7～10d,观察其对心功能和非侵入性血流动力学参数的影响。结果纽约心脏病协会(NYHA)心功能级别改善,非侵入性血流动力学参数明显改善:肺动脉收缩压从(69.9±18.3)mm Hg下降至(35.8±13.0)mm Hg,每搏输出量治疗前(36.2±16.7)mL,治疗后(37.7±18.4)mL,动脉血气氧分压和二氧化碳分压轻微增加。血浆B型利钠肽浓度治疗前(7 799.2±6 451.6)pg/mL,治疗后(1 887.7±1 263.7)pg/mL,治疗后明显下降,差异有统计学意义(P<0.01)。结论静脉注射前列地尔治疗能明显降低重度HPAH患者肺动脉压力,改善心功能。

Clinical effect of intravenous Iloprost on severe high altitude pulmonary arterial hypertension

Objective To observe the effect of intravenous Iloprost on severe high altitude pulmonary arterial hypertension（HPAH） . Methods 33 cases of severe HPAH received intravenous Iloprost with dose of 5--7 ng ~ kg--1 ~ b-1 at time of initiation of treatment. The time of therapy was 7--10 days. The effects of intravenous Iloprost on heart function and the parameters of hemodynamies were observed. Results Heart functional class was improved after treatment with intravenous Iloprost. At the same time, the parameters of ultrasonic echocardiography were im- proved： pulmonary arterial systolic pressure （sPAP） decreased from （69.9! 18.3）ram Hg to （35.8-1-13.0）ram Hg （P~0.01）, stroke volume increased, oxygen partial pressure and partial pressure of carbon dioxide of arterial blood gas increased. The level of brain natriuretic peptide （BNP） decreased from （7 799.2~6 451.6）pg/mL to （1 887.7~ 1 263.7）pg/mL（P＇（0.01）. Conclusion Intravenous lloprost could improve heart function and decrease pulmonary arterial systolic pressure for patients with severe HPAH.