西地那非治疗肺动脉高压的疗效及安全性研究  

Study on efficacy and safety of sildenafil for the treatment of pulmonary arterial hypertension

作　　者：闫芳[1] 夏宇[1] 李威[1] 王晶[1] 

机构地区：[1]新疆医科大学第一附属医院呼吸科,乌鲁木齐830054

出　　处：《中国临床药理学杂志》2014年第10期877-879,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的评价不同剂量西地那非治疗肺动脉高压临床疗效及耐受性。方法72例肺动脉高压者随机分为25,50,75 mg组,分别为30,24,18例,口服西地那非至目标剂量,每日3次,疗程12周。比较3组治疗前后6分钟步行实验、Borg呼吸困难指数、纽约心脏协会(NYHA)分级及血流动力学改变,同时记录药物不良反应。结果用药12周后,3组的6分钟步行试验均较治疗前增加(P<0.05);中、高剂量组6分钟步行试验改善率比低剂量组高(P<0.05)。3组间肺动脉压及右室舒张末压治疗前后变化有统计学意义(P<0.05);而3组Borg呼吸困难指数、NYHA分级改善≥1的患者比例比较差异无统计学意义(P>0.05)。3组面红、头晕及胃肠道反应差异无统计学意义(P>0.05)。结论肺动脉高压者口服西地那非可降低肺动脉压力,推荐剂量为25 mg,每日3次。Objective To evaluate the clinical efficacy and safety of dif-ferent doses of sildenafilin for the treatment of pulmonary arterial hyper -tension （PAH）.Methods Seventy -two cases of PAH patients were divided into 3 dose groups randomly （25, 50 and 75 mg, tid）, and there were 30, 24 and 18 patients, respectively.Each patient was administra-ted for 12 weeks.The data of six -minute walk test （SMWT）, borg dyspnea index, New York Heart Association （NYHA） classification and cardiopulmonary hemodynamics of each group before and after treatment were recorded and compared.Drug related adverse reactions were recor-ded.Results After taking in sildenafil for 12 weeks, six -minutes walk tests of three groups all were increased than the baseline , and the 50 and 75 mg group increased much more significantly than 25 mg group （P 〈0.05）.There was a difference among the three groups in the change of pulmonary artery pressure and right ventricular end -diastolic pressure than baseline （P 〈0.05） .Among three groups, the ratio of patients whose improvement were greater than or equal to 1 in borg dyspnea index and NYHA classification did not show statistical differences （P 〉0.05）. In comparison of the serious side effects in the three groups , such as flushing face, dizziness and gastrointestinal reactions , there was no sig-nificant difference （P 〉0.05）.Conclusion Oral sildenafil can signifi-cantly reduce pulmonary artery pressure.The recommended dose is 25 mg, tid.

关 键 词：西地那非 肺动脉高压 磷酸二酯酶抑制剂 疗效 安全性 

分 类 号：R543.2[医药卫生—心血管疾病] R977.3[医药卫生—内科学]