前列腺素E_1对小儿重症肺炎肺动脉高压影响的临床研究

目的: 探讨前列腺素E1 (PGE1 ) 对小儿重症肺炎肺动脉高压的影响, 为临床使用PGE1 辅佐治疗重症肺炎、防治肺炎并发心力衰竭提供科学依据。方法: 将40例临床诊断为重症肺炎合并心力衰竭、经彩色多谱勒超声心动图检查存在肺动脉高压而无先天性心脏病等其他可引起肺动脉高压疾病的患儿随机分为观察组及对照组各20例, 观察组在重症肺炎合并心力衰竭常规治疗的基础上, 加用微注泵持续静脉缓慢注射PGE1 50ng/kg·min, 治疗3d; 对照组只进行重症肺炎合并心力衰竭的常规治疗。结果: 观察组治疗前的肺动脉收缩压(PASP) 为51 .42±11. 36mmHg, 治疗3d后为23 .68±5. 42mmHg, 治疗前、后有显著性差异(t=2 .86, P<0 .01); 对照组治疗前的PASP为49. 36±12 .75mmHg, 治疗3d后为46. 15±9 .36mmHg, 治疗前、后差异无显著性(t=1 24, P>0 05); 两组病例治疗前PASP无显著性差异(t=1 .16, P>0 .05), 而治疗3d后则有显著性差异(t=2 .73, P<0. 01)。结论: PGE1 可有效降低重症肺炎合并心力衰竭时的肺动脉高压, 有助于减轻右心负荷, 提高重症肺炎合并心力衰竭的抢救成功率。

Clinical study of the effect of prostaglandin E1 on pulmonary arterial hypertension in children with severe pneumonia

Objective:By exploring the effect of prostaglandin E 1 (PGE 1) on pulmonary arterial hypertension in children with severe pneumonia to supply the scientific basis for PGE 1 used in adjuvant treatment of severe pneumonia and prevention of pneumonia complicated with heart failure. Methods:40 children diagnosed as severe pneumonia complicated with heart failure, with pulmonary arterial hypertension and confirmed by color Doppler ultrasound without congenital heart diseases and other diseases resulting in pulmonary arterial hypertension were randomly and averagely divided into observation group (continuously given 50 ng·kg -1 ·min -1 PGE 1 via venous for 3 days ) and control group (routine therapy).Results:There were significant differences in pulmonary arterial systolic pressure (PASP) before treatment 〔(51.42±11.36)mmHg〕 and 3 days after treatment 〔(23.68±5.42)mmHg〕 ( t=2.86, P <0.01) in observation group. There were no significant differences in PASP before treatment 〔(49.36±12.75)mmHg〕 and 3 days after treatment 〔(46.15±9.36)mmHg〕 ( t=1.24, P >0.05) in control group. There were no significant differences in PASP between two groups ( t=1.16, P >0.05), but significant differences at 3 days after treatment between two groups ( t=2.73, P <0.01). Conclusion:PGE 1 could effectively reduce PASP of severe pneumonia complicated with heart failure, which could be helpful to decrease of right ventricle load and improvement of success rate of salvage for severe pneumonia complicated with heart failure.