波生坦用于儿童CHD相关PAH治疗的临床效果观察  

Clinical efficacy observation of bosentan for children with CHD associated PAH

作　　者：韩蕴卿[1] 

机构地区：[1]山东省莱芜市人民医院小儿科,山东莱芜271100

出　　处：《中国生化药物杂志》2014年第5期127-129,共3页Chinese Journal of Biochemical Pharmaceutics

基　　金：山东省医药卫生科技发展计划项目(2011HZ064)

摘　　要：目的 探讨非选择性内皮素受体拮抗剂波生坦用于治疗儿童先天性心脏病(congenital heart disease,CHD)相关性肺动脉高压(puhmonary arterial hypertension,PAH)的临床效果及安全性.方法 选取2011年4月～2012年3月山东省莱芜市人民医院收治的32例先天心脏病患儿,随机分为治疗组和对照组(n=16).对照组进行常规强心利尿治疗,治疗组在对照组的基础上应用波生坦进行治疗,治疗6个月后观察2组患者肺动脉压、肺血管阻力、6 min步行实验、心率(heart rate,HR)、心功能及肝肾功能指标的变化情况差异.结果 治疗前对照组和治疗组的肺动脉收缩压、肺动脉舒张压、肺动脉阻力、HR比较差异不显著;治疗后对照组和治疗组肺动脉收缩压、舒张压均显著降低(P＜0.05),肺动脉阻力、HR无显著性差异,且治疗后治疗组患儿肺动脉收缩压、舒张压显著低于对照组,差异有统计学意义(P＜0.05).治疗前2组6 m in步行距离差异不显著,治疗后治疗组的步行距离显著长于对照组(P＜0.05).治疗前后2组尿素氮(urea nitrogen,BUN)、肌酐(ereatinine,CREA)、谷丙转氨酶(alanine aminotransferase,AST)、谷草转氨酶(aspartate aminotransferase,ALT)差异均不显著.结论 非选择性内皮素受体拮抗剂用于治疗CHD相关性PAH能改善肺动脉压及提高肺活动耐量,具有较好的安全性.Objective To study the non-selective endothelin receptor antagonist bosentan for treatment of children with congenital heart disease(congenital heart disease,CHD) associated pulmonary arterial hypertension( pulmonaryarterial hypertension,PAH) the clinical efficacy and safety. Methods From 2011 April to 2012 March in Laiwu People's Hospital of Shandong Province from 32 cases of congenital heart disease in children,were randomly divided into treatment group and control group( n = 16). Control group was given routine cardiac diuretic therapy,treatment group were treated with bosentan on the basis of the control group,pulmonary arterial pressure,pulmonary vascular resistance,6 min walk test,heart rate( HR),the changes of cardiac function and liver function index difference were observed 6 months after treatment. Results Before treatment,pulmonary artery systolic pressure,diastolic pulmonary artery pressure,pulmonary arterial resistance and HR between control group and treatment group,were not significant; after treatment,the pulmonary arterial systolic pressure,diastolic blood pressure in treatment group and control group significantly decreased(P <0.05),those indexes in treatment group were significantly lower than the control group,the difference was statistically significant(P < 0.05). Before treatment,two groups of children with LVEDD,EF,RVD,PGVT were not significantly different. After treatment,the treatment group was significantly longer than that of the control group in 6 min walking distance( P < 0. 05). Before and after treatment in two groups: BUN,CREA,AST,ALT were not significantly different. Conclusion Non-selective endothelin receptor antagonist for the treatment of CHD associated PAH could improve the pulmonary arterial pressure and improve pulmonary exercise tolerance with good security.

关 键 词：非选择性内皮素受体拮抗剂 波生坦 儿童先天性心脏病 肺动脉高压 临床效果 

分 类 号：R725[医药卫生—儿科]