安立生坦治疗艾森曼格综合征的疗效及安全性  

Therapeutic effect and safety of ambrisentan on Eisenmenger syndrome

作　　者：刘洋[1] 张刚成[1] 卢蓉[1] 余莹[1] 

机构地区：[1]武汉亚洲心脏病医院肺重症监护室,湖北武汉430022

出　　处：《心血管康复医学杂志》2015年第3期288-292,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：国家十二五科技支撑项目(2011BAI11B15)

摘　　要：目的：观察安立生坦治疗艾森曼格综合征（ES）的临床疗效。方法：2011年4月-2014年3月在武汉亚洲心脏病医院住院ES患者79例,分为安立生坦组（38例,地高辛＋安立生坦治疗）及常规治疗组（41例,地高辛治疗）,治疗12周。观察两组病例在治疗前及治疗12周后6min步行距离（6MWD）、WHO肺动脉高压心功能分级（WHO FC）等。同时观察安立生坦组治疗前后血流动力学参数[包括平均肺动脉压（mPAP）、全肺阻力（TPR）、肺/体循环流量比（Qp/Qs）]的变化。结果：与治疗前比较,12周后安立生坦组患者6MWD明显增加,TPR明显下降,Qp/Qs明显升高,WHO FC心功能分级明显好转（P〈0.05或〈0.01）。与常规治疗组比较,12周后安立生坦组6MWD[（356.8±74.1）m比（393.7±69.2）m]明显增加、BNP水平[（832.5±422.2）ng/L比（646.6±297.1）ng/L]明显降低、WHO FC心功能分级（I/II级,67.5%比86.8%）明显改善（P〈0.05或〈0.01）,安立生坦组无死亡病例,不良反应轻微,常规治疗组有1例患者死亡。结论：口服安立生坦可以显著改善艾森曼格综合征患者心功能及运动能力,安全性和耐受性良好。Objective：To observe therapeutic effect of ambrisentan on Eisenmenger syndrome （ES） .Methods：A total of 79 ES patients ,who hospitalized in Wuhan Asia Heart Hospital from Apr 2011 to Mar 2014 ,were divided into ambrisentan group （n=38 ,received digoxin combined ambrisentan treatment） and routine treatment group （n=41 , received digoxin treatment） ,and both groups were treated for 12 weeks .The 6min walking distance （6MWD） , WHO functional class （WHO FC） of pulmonary hypertension etc .were observed in both groups before and 12-week after treatment .Changes of hemodynamic parameters ,including mean pulmonary artery pressure （mPAP） ,total pulmonary resistance （TPR） and ratio of pulmonary circulating flow to system circulating flow （Qp/Qs） etc .,were observed in ambrisentan group before and after treatment . Results：Compared with before treatment , after 12 weeks ,6MWD significantly rose ,TPR significantly reduced ,Qp/Qs significantly increased and WHO FC signifi-cantly improved in ambrisentan group ,P〈0.05 or 〈0.01. Compared with routine treatment group after 12 weeks , there was significant rise in 6MWD [ （356.8 ± 74.1） m vs .（393.7 ± 69.2） m] ,significant reduction in BNP level [（832.5 ± 422.2） ng/L vs .（646.6 ± 297.1） ng/L] and significant improvement in WHO FC （class I/II ,67.5% vs . 86.8% ） in ambrisentan group ,P〈0.05 or 〈0.01. No patient died ,the adverse reactions were mild in ambrisentan group ;one case died in routine treatment group .Conclusion：Oral ambrisentan can significantly improve heart func-tion and exercise capacity in patients with Eisenmenger syndrome ,and it possesses good safety and tolerance .

关 键 词：Eisenmenger复合征 高血压 肺性 安立生坦 

分 类 号：R541.1[医药卫生—心血管疾病]