硝苯吡啶对低氧性肺动脉高压的疗效观察

目的：探讨硝苯吡啶对低氧性肺动脉高压（HPH）的疗效观察。方法：在海拔5 000 m以上高原,对临床确诊的20例HPH患者口服硝苯吡啶10mg/次,每日2次,服用3个月,治疗前后采用超声心动图检测右室舒张末前后径（RVED）、右室前壁厚度（RVAW）、右室流出道（RVOT）、肺动脉主干内径（MPA）和三尖瓣反流,同时采血检测超氧化物歧化酶（SOD）、丙二醛（MDA）、一氧化氮（NO）及一氧化氮合酶（NOS）的含量。结果：治疗后较治疗前RVED、RVAW、RVOT、MPA降低,有非常显著性差异（P〈0.05或0.01）;三尖瓣反流发生率明显降低（P〈0.01）;治疗后较治疗前SOD、NOS、NO增高,MDA降低,有显著性差异（P〈0.05或0.01）。结论：硝苯吡啶对低氧性低肺动脉高压具有一定的治疗作用,除钙拮抗外,还存在抗氧化作用。

Treatment Effect of Nifedipine on Hypoxic Pulmonary Hypertension at High Altitude

Objective： To observe the treatment efficacy of nifedipine on hypoxic pulmonary hypertension （HPH） at high altitude. Methods：20 volunteers who had been identified to have clinically HPH at 5 000m alti- tudes, were collected in this study. They were administered orally nifedipine, 10mg / time, 2 times / d for three months, and accepted the echocardiograph to evaluate right ventrieular end -diastolic dimension （RYED）, right ventricular anterior wall （RVAW）, right ventricular outflow tract （RVOT）, Main pulmonary artery diameter （MPA） and tricuspid regurgitation （TR） before and after treatment; meanwhile, level of superoxide dismutase （SOD） , malonaldehyde （MDA） , nitrogen oxide （NO） , nitric oxide synthase （NOS） were examined. Results： RVED, RVAW, RVOT, MPA, TR and MDA level were significantly decreased after treatment compared with those before treatment （ P 〈 0.05 or 〈 0.01 ） ; Level of SOD, NOS and NO were significantly higher after treatment than those before treatment （P 〈0.05 or 〈0.01 ））. Conclusions：Nifedipine could degrade hypoxie pulmonary hyper- tension at high altitude duo to its effect of anti -oxidation and calcium antagonism.