吸入伊洛前列素在肺动脉高压急性肺血管反应试验中的应用  

Application of iloprost inhalation in test of acute pulmonary vascular reactivity to pulmonary hypertension

作　　者：翟莉[1] 吕豪[1] 黄洁[1] 王晓瑾[1] 熊长明 

机构地区：[1]武警北京总队第二医院心内科,北京100037 [2]中国医学科学院阜外心血管病医院肺血管病诊治中心,北京100037

出　　处：《军医进修学院学报》2012年第6期599-601,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的观察先天性心脏病合并肺动脉高压患者吸入伊洛前列素前后血流动力学变化。方法 34例先天性心脏病患者,其中房间隔缺损10例、室间隔缺损19例、动脉导管未闭2例、室间隔缺损合并动脉导管未闭2例、室间隔缺损合并房间隔缺损1例,均在接受右心导管检查后进行吸入氧气和吸入伊洛前列素试验,记录吸氧前后、吸药前后的血流动力学指标变化。结果平均肺动脉压吸氧前、吸氧后和吸药后分别为(74.53±12.48)mmHg(1mmHg=0.133kPa),(64.35±14.44)mmHg,(57.41±12.94)mmHg,吸氧及吸药后平均肺动脉压均明显降低,且吸药后更显著(P<0.01);全肺阻力吸氧前、吸氧后和吸药后分别为(1 291.85±417.19)dyn/(s.cm5),(958.03±355.83)dyn/(s.cm5),(762.59±296.86)dyn/(s.cm5),吸氧后及吸药后全肺阻力明显降低,且吸药后更显著(P<0.01);心脏指数吸氧前、吸氧后和吸药后分别为(2.43±0.44)L/(min.m2),(3.07±0.58)L/(min.m2),(3.34±0.58)L/(min.m2),吸氧及吸药后心脏指数明显增加,且吸药后更显著(P<0.01)。同时患者心率及血压均无明显变化。吸氧及吸药试验的阳性率分别是为64.71%和76.47%,两者比较有统计学差异(P<0.05)。结论与吸氧试验相比,吸入伊洛前列素进行急性肺血管试验可以更好地判断肺血管的反应性。Objective To observe the hemodynamic changes in patients with congenital heart disease accompanying pulmonary hypertension before and after iloprost inhalation.Methods Thirty-four patients with congenital heart disease（10 with atrial septal defect,19 with ventricular septal defect,2 with patent arterial duct,2 with ventricular septal defect accompanying patent arterial duct,and 1 with atrial septal defect accompanying ventricular septal defect） underwent right heart catheterization.Their hemodynamic changes were recorded after inhalation of oxygen and iloprost.Results The mean pulmonary arterial pressure and the total pulmonary resistance were significantly lower in the patients after oxygen and iloprost inhalation than before oxygen inhalation（（64.35±14.44）mmHg and（57.41±12.94）mmHg vs（74.53±12.48）mmHg,（958.03±355.83）dyn/（s·cm5） and（762.59±296.86）dyn/（s·cm5） vs（1 291.85±417.19）dyn/（s·cm5）,P0.01）.The cardiac index was significantly higher in the patients after oxygen and iloprost inhalation than before oxygen inhalation（（3.34±0.58）L/（min·m2） vs（3.07±0.58）L/（min·m2） and（2.43±0.44）L/（min·m2）,P0.01）,but no significant change was observed in their heart rate and blood pressure.The positive rate of oxygen inhalation was significantly lower than that of iloprost inhalation（64.71% vs 76.47%,P0.05）.Conclusion Iloprost inhalation can judge the pulmonary reactivity better than oxygen inhalation.

关 键 词：先天性心脏病 肺动脉高压 伊洛前列素 血管反应试验 

分 类 号：R654.2[医药卫生—外科学]