波生坦对房间隔缺损合并重度肺动脉高压女性患者血管内皮舒张功能的影响  

Bosentan on vascular endothelial diastolic function in female patients with secundum atrial septal defect and severe pulmonary artery hypertension

作　　者：潘晓杰[1] 刘佳[1] 姜一农[1] 王珂[1] 旅朝霞[1] 郭然[1] 

机构地区：[1]大连医科大学附属第一医院心内科,116011

出　　处：《心肺血管病杂志》2015年第11期812-815,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:观察波生坦对继发孔型房间隔缺损(ASD)合并重度肺动脉高压(PAH)女性患者血管内皮舒张功能的短期影响。方法:给予11例经右心导管检查确诊为先天性心脏病,ASD合并PAH的女性患者,给予波生坦62.5mg,每日2次,口服4周治疗。记录并比较患者治疗前、后6分钟步行距离(6MWD)、WHO心功能分级、内皮依赖性(FMD)和非内皮依赖性血管舒张功能(EID)及超声心动图检测指标。结果:波生坦治疗4周后,患者6MWD由(238±173.0)m增至(307±141.4)m(P=0.005);WHO心功能分级3例患者(27%)降低1级,8例患者维持原有分级不变;治疗前、后患者的肺动脉收缩压和平均压呈下降趋势,但差异无统计学意义;FMD由治疗前的2.7(2.0,3.3)%升至4.4(3.3,5.6)%(P=0.033),EID无显著变化。患者随访期间未观察到严重不良反应。结论:半剂量波生坦短期治疗,可以显著改善ASD合并PAH女性患者肱动脉内皮依赖性血管舒张功能。Objectives： To observe the short-time effect of bosentan in female patients with congenital secundum atrial septal defect（ ASD） and severe pulmonary artery hypertension（ PAH）. Methods： 11 female patients definitely diagnosed of ASD and PAH by right heart catheterization were enrolled and prescribed of bosentan 62. 5mg,bid for 4 weeks. 6 minutes walking distance（ 6MWD）,WHO heart function,echocardiographic results and branchial flow-mediated dilation（ FMD） were recorded for statistical analysis before and 4weeks after the treatment. Results： 6MWD increased from（ 238 ± 173. 0） m to（ 307 ± 141. 4） m（ P = 0. 005） after 4 weeks（ P 0. 01）. 3（ 27%） patients decreased with 1 grade of WHO heart function classification and 8patients maintained the initial grade. No significant changes were seen in pulmonary artery systolic pressure and pulmonary artery mean pressure. Branchial FMD elevated from 2. 7（ 2. 0,3. 3） % to 4. 4（ 3. 3,5. 6） %（ P =0. 033）. No severe side effects were seen during follow-up. Conclusion： 4-weeks ＇treatment of half-dose Bosentan improved FMD significantly in female patients with congenital secundum ASD and severe PAH.

关 键 词：内皮素受体拮抗剂 房间隔缺损 肺动脉高压 血管内皮舒张功能 

分 类 号：R54[医药卫生—心血管疾病]