靶向药物联合介入封堵治疗动脉导管未闭合并艾森门格综合征5例效果观察  

Effect Observation of Targeted Drug Combined with Interventional Therapy in Treatment of 5 Patients with Patent Ductus Arteriosus Complicated by Eisenmenger Syndrome

作　　者：卢蓉[1] 张刚成[1] 尚小珂[1] 沈群山[1] 周红梅[1] 刘洋[1] 

机构地区：[1]武汉亚洲心脏病医院先天性心脏病中心,武汉430022

出　　处：《解放军医药杂志》2014年第6期12-16,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家十二五科技支撑项目(2011BAI11B15)

摘　　要：目的探讨动脉导管未闭（patent ductus arteriosus,PDA）合并艾森门格综合征（eisenmenger syndrome,ES）应用靶向药物联合介入封堵治疗的效果。方法选择2011年6月—2013年10月诊断为重度肺动脉高压（pulmonary arterial hypertension,PAH）的PDA患者5例,术前行右心导管检查肺循环血流量/体循环血流量在1.0～1.5。入院时行急性肺血管扩张试验和试封堵试验,阳性患者行介入封堵术,所有患者术后接受规范靶向药物治疗,治疗后6、12个月综合评估介入封堵治疗指征和治疗效果。结果本组随访12个月,无一例死亡,3例成功行介入封堵术,术后肺动脉压力及肺血管阻力均呈下降趋势,1例经靶向药物治疗6个月后仍无手术指征,但一般情况好转,1例接受靶向药物治疗1个月后放弃治疗,病情逐步恶化。结论经积极靶向药物、介入封堵治疗可使部分PDA合并ES患者获益。Objective To explore the effect of targeted drugs combined with interventional therapy in treatment of patent ductus arteriosus（ PDA） complicated by Eisenmenger syndrome（ ES）. Methods The value of pulmonary blood flow / systemic blood flow（ Qp /Qs） was 1. 0- 1. 5 by right heart catheterization in 5 PDA patients with severe pulmonary arterial hypertension（ PAH） during June 2011 and October 2013. The trial plugging and acute pulmonary vasodilatation tests were performed upon admission,and then patients with positive results underwent interventional therapy. All patients received standard treatment of targeted drug. The indicatio curativa and effect of interventional therapy were comprehensively evaluated after the treatment for 6 and 12 months. Results There was no death case during 12 months of follow-up. Three patients underwent interventional surgery successfully,and the values of pulmonary artery pressure and pulmonary vascular resistance were decreased; one patient still had no surgical indication after targeted drug for 6months,but the general condition improved; one patient abandoned the treatment after targeted drug for one month,and his condition gradually worsened. Conclusion Some patients with PDA complicated by ES may benefit from the active targeted drug combined with interventional therapy.

关 键 词：高血压 肺性 动脉导管未闭 介入 心间隔封堵装置 

分 类 号：R544[医药卫生—心血管疾病] R541.1[医药卫生—内科学]