吸入伊洛前列腺素在先天性心脏病伴发肺动脉高压患者中的急性血管反应试验

目的:观察吸入伊洛前列腺素对先天性心脏病伴发肺动脉高压者的急性血管反应。方法:予15例患者(室间隔缺损10例,房间隔缺损3例,动脉导管未闭及心内膜垫缺损各1例)吸入氧气15min,而后吸入20μg伊洛前列腺素,测量吸氧前后、吸药后即刻、15min及30min的肺动脉和股动脉压并取各部位血测值。结果:吸药后即刻肺动脉平均压及全肺阻力较吸氧前明显降低(P<0.001),而左心排血指数未见明显变化(P=0.244),试验过程中患者未出现不良反应。结论:在急性血管反应试验中,使用雾化吸入的伊洛前列腺素可以安全、有效的在短时间内选择性扩张肺血管、降低肺动脉压力及肺循环阻力,而对体循环影响较小。

Acute hemodynamic response of inhaled iloprost in secondary pulmonary hypertension of congenital heart disease

Objective： To observe the acute hemodynamic response of iloprost in secondary pulmonary hypertension of congenital heart disease. Method： Fifteen cases with secondary pulmonary hypertension of congenital heart disease（10 patients with ventricle septal defect, 3 patient with atrium septal defect, 1 patient with patent ductus arteriosus, 1 patient with endocardial cushion defect）. All of them sequentially inhaled oxygen 15 min and following 20 ttg of iloprost, and the response on hemodynamic and blood gases were monitored. Result： All patients displayed a significant reduction in mean pulmonary arterial pressure （PAP） and total pulmonary resistance （TPR）（ P 〈 0.001 ） immediately after inhaled iloprost. There was no seriously decrease in the left cadiac index （CI）（ P = 0.244）. There was no major adverse effects during this test. Conclusion： during acute drug testing, inhaled ilopmst lowered PAP safely and efficaciously, Ilopmst selectively dilated pulmonary vascular and is no more effect on systemic circulation.