不同剂量西地那非术后治疗婴幼儿先天性心脏病合并肺动脉高压的临床研究  

Clinical Study on Treatment of the Pulmonary Hypertension in Infants with Congenital Heart Disease by Different Dosages of Sildenafil After Surgery

作　　者：马超[1] 孟保英[1] 王元祥[1] 彭乐[1] 赵春玉[1] 张青[1] 潘晓兰[1] 王涛[1] 

机构地区：[1]广东省深圳市中国医科大学深圳儿童医院心血管中心,518026

出　　处：《中国医药指南》2010年第22期16-18,共3页Guide of China Medicine

摘　　要：目的探讨不同剂量西地那非对婴幼儿先天性心脏病合并肺动脉高压的疗效及不良反应,以便能制定婴幼儿最佳用药方案,减少不良反应的发生。方法先天性心脏病择期手术患儿128例按西地那非剂量分为4组:0.3mg/kg组(A组)、0.6mg/kg组(B组)、1.2mg/kg组(C组),1.8mg/kg组(D组),连续记录4组给药前、给药后3、7和14d的体动脉压、肺动脉压、动脉血氧饱和度、氧合指数,同时观察用药后患儿是否有不良反应。术后1个月复查体循环血压、肺动脉压。结果①部分高剂量患儿出现轻微不良反应,调整剂量后自行消失。②肺动脉收缩压动脉、血氧饱和度和氧合指数的比较:组内比较:各组用药前与用药3d比较差异均有统计学意义。组间比较:a.用药3d各组比较:A与B组P>0.05;C与D组比较P>0.05;A与C比较P<0.05;A与D比较P<0.05;B与C比较P<0.05;B与D比较P<0.05;b.用药7、14d两两组间比较,均为P>0.05。③体动脉收缩压:各组的组内和组间比较均为P>0.05。④复查肺动脉压组间比较均为P>0.05。结论婴幼儿应用西地那非不良反应轻;不同剂量用药3d后,各组所有患儿的肺动脉高压均有明显改善;短期内高剂量比低剂量的西地那非的疗效明显,但长期应用的降压效果是一致的,婴幼儿给药从小剂量(0.3mg/kg)开始,给药间隔则经验性的延长。Objective To evaluate the safety and therapeutic efficacy of different dosages of sildenafil for treating the pulmonary hypertension in infants with congenital heart disease after surgery,and to work out best therapeutic regimen.Methods 128 Infants with congenital heart disease combinating the pulmonary hypertension undergoing cardiac surgery were divided into four groups （n=32）,0.3mg/kg（group A）,0.6 mg/kg（group B）,1.2 mg/kg（group C） and 1.8 mg/kg（group D） respectively.The clinical symptoms were observed,side effects were recorded accordingly.The levels of pulmonary artery pressure,oxygen saturation of arterial blood and the Oxygenation index were measured before treatment,3day,7 day and 14 day after treatment .The levels of pulmonary artery pressure was counterchecked a month after treatment.Results ①Subsection of high dose patient appear light adverse reactions,adverse reaction was eliminated after adjusting dosage.②Comparison of the levels of pulmonary artery pressure,oxygen saturation of arterial blood and the oxygenation index： difference among within group： the differences for any group were significant between after and before using the drug;Comparison between any two groups： a.there were not statistical significance 3 day after treatment（P〉0.05）,between the group A and the group B,between the group C and the group D;However,the Differences were significant （P〈0.05） between the group A and the group C,between the group A and the group D,between the group B and the group C,between the group B and the group D.b.7 day and14 day after using the drug： the comparison in any two groups were not signi？cant（P〉0.05）.③The comparison of body arterial pressure in any two groups were not significant （P〉0.05）.④A month after using the drug,the comparison of pulmonary artery pressure counterchecked were not significant （P〉0.05） in any two groups.Conclusions Adverse reactions of sildenafil is light for Infants in reasonable dose;compare low dose,the curativ

关 键 词：婴幼儿 西地那非 肺动脉高压 先天性心脏病 

分 类 号：R725.4[医药卫生—儿科]