前列地尔注射液治疗心脏病患者体外循环术后肺动脉高压的疗效观察

目的:观察前列地尔注射液对心脏病患者体外循环(CPB)术后肺动脉高压的治疗效果。方法:筛选出42例CPB术后合并肺动脉高压的心脏病患者,经中心静脉置管以20～40 ng.kg-1.min-1的速度泵入前列地尔注射液,比较用药前和用药后15、30、60 min患者的平均肺动脉压(mPAP)、平均动脉压(mSAP)、平均肺动脉压与动脉压之比(PP/PS)、心脏指数(CI)、肺血管阻力指数(PVRI)、体循环血管阻力指数(SVRI)等指标的变化。结果:患者用药后各时点的mPAP、PP/PS均较药前有显著降低(P均<0.01);患者用药后各时点的PVRI较用药前均有显著降低(P均<0.01),且呈逐渐下降趋势;CI在用药后各时点较用药前均有明显增高(P<0.05);mSAP、SVRI无显著变化(P>0.05)。结论:CPB术后应用前列地尔注射液,能有效降低肺动脉压、减轻右心负荷、增加心排量、维持血流动力学稳定,可增加手术安全性。

Efficacy of Prostaglandin E1 for Pulmonary Hypertension in Patients with Cardiac Disease After Undergoing Cardiopulmonary Bypass

OBJECTIVE:To evaluate the therapeutic efficacy of prostaglandin E1(PGE1) injection for pulmonary hypertension in patients with cardiac diseases after undergoing cardiopulmonary bypass(CPB).METHODS: 42 patients with cardiac diseases who developed pulmonary hypertension after undergoing CPB were infused with PGE1 at the rate of 20-40 ng·min-1·kg-1 by means of central vena catheterization.Mean pulmonary artery pressure(MPAP),mean systemic arterial pressure(MSAP),the ratio of MPAP to MSAP(PP/PS),cardiac index(CI),pulmonary vascular resistance index(PVRI) and systemic vascular resistance index(SVRI) were monitored at 0,and 15 min,30 min and 60 min.RESULTS: The mPAP,PP/PS and PVRI at 15 min,30min and 60 min were all significantly lower than before PGE1 administration(all P<0.01);PVRI was decreased significantly at different time point(all P<0.01) showing downward tendency;CI was significantly increased at each time point as compared with before PGE1 administration(P<0.01);however,there were no significant changes in MSAP and SVRI compared with before PGE1 administration(P>0.05).CONCLUSION: Use of PGE1 in patients after undergoing CPB resulted in effectively decreased pulmonary hypertension,reduced cardiac load(cor dextrum),increased cardiac output,stable hemodynamics and enhanced surgical safety.