氯沙坦治疗肺动脉高压的初步探讨

目的：探讨氯沙坦在治疗肺动脉高压中的作用，以评价其对慢性肺源性心脏病（肺心病）的疗效。方法：60例慢性阻塞性肺疾病同时伴有肺动脉高压病人分成两组，均给予常规吸氧、抗感染、祛痰、平喘等治疗。治疗组加服氯沙坦，50mg/次，每日一次。疗程2周。治疗前和2周时测定肺动脉压。结果：两组治疗后肺动脉压均有显著下降（P＜0．01）；治疗组肺动脉压的下降与对照组比较有极显著的差异（P＜0．001），动脉血氧分压的上升与对照组比较有明显差异（P＜0．05）。结论：慢性阻塞性肺疾病急性加重期病人通过常规吸氧、抗感染、祛痰、平喘等治疗可使肺动脉压降低，加用氯沙坦可使肺动脉压下降更为明显，并使动脉血氧分压上升，提示氯沙坦可用于肺心病的治疗。

Observation of effect of losartan on pulmonary hypertension

Objective:To investigate the efficacy of losartan in the lowering of pulmonary hypertension(PH) , in order to evaluate its role in the treatment of patients with chronic cor pulmonale.Methods:Sixty consecutive patients hospitalized for exacerbation of chronic obstructive pulmonary disease (COPD) with PH werre randomly assigned to 2 groups: control group and treatment group. Basic treatment involving oxygen therapy, antibiotics and bronchodilators were used in patients of both groups and patients of treatment group received in addition 50mg of losartan once daily. The course of treatment lasted for two weeks. In every patient, baseline pulmonary artery pressure (PAP) was measured and the measurement was repeated after 2 weeks. Results:Every patient of both groups gained significant decrease in PAP after treatment (P<0.01). Patients of treatment group had more significant PAP decrease as compared with patients of control group (P<0.05).Conclusion:In acute exacerbations of patients with COPD, PAP can be decreased by means of conventional oxygen therapy, antibiotics and bronchodilators. The significant reduction in PAP by the addition of losartan shows that losartan is useful in the treatment of patients with COPD.