口服氨茶碱、培哚普利、硝苯地平对高海拔5000m以上地区移居者低氧性肺动脉高压的治疗效果

目的:观察口服氨茶碱片、培哚普利片、硝苯地平片对高海拔地区(5000 m以上)移居者低氧性肺动脉高压的治疗效果。方法:选择驻守在海拔5000 m以上地区1年、经超声心动图及心电图确诊为低氧性肺动脉高压的男性汉族青年42人,随机分为3组,A组(氨茶碱组:n=14人)口服氨茶碱片,每次0.1 g,3/d;B组(培哚普利组:n=14人)口服培哚普利片,每次4 mg,1/d;C组(硝苯地平组:n=14人)口服硝苯地平片,每次10 mg,2/d。3个月后检测服药前后6 min步行距离,并对慢性高原病症状进行服药前后调查对比。结果:服药后与服药前低氧性肺动脉高压治疗效果比较:A组10人有效,有效率为71.43%;B组12人有效,有效率为85.71%;C组9人有效,有效率为64.29%。服药后3组青年6 min步行距离较服药前均增加,有非常显著性差异(P<0.01),B组较A、C组增加,有显著性差异(P<0.05,P<0.01),A组与C组无统计学差异(P>0.05)。服药后3组青年慢性高原病症状较服药前均减轻,有非常显著性差异(P<0.01),服药后B组较A、C组减轻,有显著性差异(P<0.05),A组与C组无统计学差异(P>0.05)。结论:在高海拔地区口服氨茶碱片、培哚普利片、硝苯地平片均可有效降低低氧性肺动脉高压,提高运动耐力,培哚普利片的治疗效果明显优于氨茶碱片和硝苯地平片。

Clinical effect of three drugs on the hypoxic pulmonary arterial hypertension ( H - PAH) above 5000 m altitude

Objective:To observe the clinical effect of prescribed Aminophylline,Perindopril and Nifedipine on patients with hypoxic pulmonary arterial hypertension(H-PAH) at high altitude.Methods :Forty-two patients with H-PAH comfirmed by echocardiography and electrocardiogram,and who had been at high altitude for 1 year were randomly divided into three groups,group A receiving 100 mg of Aaminophylline orally 3 times a day,group B receiving 4 mg of Perindopril orally once a day,and group C receiving 10 mg of Nifedipine orally twice a day,with 14 patients in each group.The effect was measured by comparing the changes of the distance of six minutes walk and the symptomatic score of chronic mountain sickness(CMS).Results: Ten(71.43%)patients were responded to Aminophylline successfully,12(85.71%)patients to Perindopril,and 9(64.29%) patients to Nifedipine respectively.The distance of six minutes walk was significantly increased while the symptomatic score of CMS was decreased in all the groups after 3 months treatment(P<0.01).Compared with group A and group C,the distance was significantly increased(P<0.05 or P<0.01) and the score was significantly decreased(P<0.05) in group B,but there was no significant difference in the changes of the distance and the scores between group A and C(P>0.05).Conclusion: Aminophylline,Perindopril and Nifedipine tablets oral therapy in patients with H-PAH is useful to decrease pulmonary arterial pressure and improve the tolerance to activity,wheres Perindopril has an advantage over the other drugs.