超声心动图对雾化吸入硝普钠治疗先天性心脏病肺动脉高压疗效的评价

目的 观察雾化吸入硝普钠治疗小儿先天性心脏病肺动脉高压的疗效.方法 选择28例超声确诊伴有肺动脉高压的先天性心脏病患儿,应用超声心动图于雾化吸入硝普钠（5 mg/ml）前、吸入30 min后分别测量、计算肺动脉收缩压（PASP）、肺动脉舒张压（PADP）、左右心Tei指数及左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）;同时在雾化吸入硝普钠前及后5、10、20及30 min观察血氧饱和度（SaO2）、血压、心率的变化.结果 与雾化吸入硝普钠前相比,吸入30 min后PASP、PADP、Tei指数均有下降（P＜0.01）,SaO2吸入5 min后有升高趋势（P＜0.01）,而血压、心率在吸入后5、10、20及30 min各时间点与吸入前相比差异无统计学意义（P＞0.05）.结论 超声心动图可评价雾化吸入硝普钠治疗先天性心脏病肺动脉高压的疗效,证实雾化吸入硝普钠可选择性降低肺动脉压力,改善心功能,提高动脉氧分压.

The effects of nebulized sodium nitroprusside treatment in patients with pulmonary hyperension secondary to congenital heart disease by echocardiography

Objective To investigate the efficacy of nebulized sodium nitroprusside （ neb-SNP ） in patients with pulmonary hypertension （PH） secondary to congenital heart disease （CHD）. Methods A total of 28 patients suffered from PH for CHD were treated by 5 mg/ml nebulized SNP. The pulmonary artery systolic pressure （ PASP）, pulmonary artery diastolic pressure （PADP） , Tel index and left ventricular ejection fraction（LVEF）, left ventricular short-axis fractional shortening （LVFS）, monitoring oxygen saturation （SaO2）,blood pressure （BP）and heart rate （HR） before and 30 minutes after inhalation were measured. Results The parameters of PASP, PADP and Tel index decreased obviously and the SaO2 increased significantly in 5 minutes after inhalation of SNP treatment to the elementary value （P 〈 0.01 ）, while the BP and HR were rarely altered all time （ P 〉 0.05 ）. Conclusions Echocardiograpb can evaluate the therapy effects of neb-SNP on PH secondary to CHD. The inhalation of SNP can selectively lower pulmonary artery pressure and improve the cardiac function and oxygen pressure.