西地那非治疗新生儿持续肺动脉高压18例

目的 探讨西地那非对新生儿持续肺动脉高压(PPHN)的疗效.方法PPHN患儿30例,分为治疗组18例和对照组12例.两组患儿均给予氧疗和机械通气等常规治疗.治疗组患儿口服西地那非 0.5 mg.kg^-1,q6 h,共3 d,比较治疗前和治疗后3 d的动脉氧合指数(OI)、氧分压(PaO₂)及肺动脉压(PAP)的变化.结果治疗组和对照组治疗3 d后PaO2较治疗前均明显上升(P<0.01),OI均明显下降(P<0.01或P<0.05);治疗组PaO₂、OI改善较对照组明显,差异有统计学意义(P<0.01).治疗后两组患儿PAP均较治疗前明显下降(均P<0.01),治疗组PAP下降较对照组明显,差异有统计学意义(P<0.01).治疗组未出现明显血压改变和其他不良反应.结论口服西地那非对继发性PPHN有快速降低PAP和提高动脉氧合的作用,且用药安全,可作为PPHN的辅助治疗.

Therapeutic Effect of Sildenafil in Persistent Pulmonary Hypertension of the Newborn

Objective To evaluate the effectiveness of sildenafil(SIL) in the treatment of neonatal pulmonary hypertension.Methods Thirty full-term and nearly full-term neonates with persistent pulmonary hypertension(PPHN) were randomly assigned to two groups: 18 infants in treatment group received 0.5 mg·kg-1 of oral sildenafil every 6 h for 3 days,and 12 infants in control group received placebo.All infants received comprehensive treatment including mechanical ventilation,expansion of infusion,and so on.Arterial blood gases were taken before and 3 days after treatment.Oxygenation index(OI) was calculated.Hear rate,blood pressure,vomit and so on were recorded.Results After 3 days of treatment,all infants get significantly higher PaO2 and lower OI and PAP(all P<0.01).Meanwhile,we observed significantly better oxygenation parameters(PaO2,OI) and lower pulmonary artery pressure(PAP) in treatment group than in control group after 3 days of SIL administration.No side effects happened in all patients treated with SIL.Conclusion Oral sildenafil is an effective and safe drug to reduce PAP and improve oxygenation in patients with PPHN.