波生坦加用吸入性treprostinil治疗肺动脉高压的安全性和有效性  

Safety and Efficacy of Inhaled Treprostinil as Add-On Therapy to Bosentan in Pulmonary Arterial Hypertension

作　　者：Channick R.N. Olschewski H. Seeger W. 郭俊 

机构地区：[1]Dr. UCSD Medical Center, La Jolla, CA, United States

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2007年第3期60-61,共2页

摘　　要：目的:评价口服波生坦加用吸入性treprostinil治疗肺动脉高压(PAH)患者的安全性和有效性。背景:在波生坦治疗PAH的同时通过吸入方式加用一种长效前列环素类似物可能是使治疗达到最佳化的安全有效的策略。Objectives: This study evaluated the safety and efficacy of inhaled treprostinil as add-on therapy to oral bosentan in patients with pulmonary arterial hypertension (PAH). Background: The addition of a long-acting prostacyclin analogue via the inhaled route might be a safe and effective strategy to optimize therapy in PAH patients on bosentan. Methods: Twelve patients with symptomatic PAH despite bosentan received either 30 μg of inhaled treprostinil 4 times daily (n=6) or 45 μg 4 times daily (n=6), via an ultrasonic nebulizer. Six-min walk distance (6MWD), functional class, and hemodynamics were assessed at baseline and 12 weeks. Results: One patient was excluded from analysis due to the subsequent finding of pulmonary capillary hemangiomatosis. In the remaining 11 patients, inhaled treprostinil was safe and well tolerated. Inhaled treprostinil was associated with an increase in 6MWD at 12 weeks(baseline 339±86, 12 week, 1 h post-inhalation 406±121 m, 67-m change, p=0.01). An improvement in 6MWD of 49 m from baseline was noted during the trough period, just before inhalation of treprostinil(p=0.009). The 6MWD improvement of at least 10%was noted in 1 of 6 patients receiving 30 μg versus 5 of 6 receiving 45 μg. Over 12 weeks, significant decreases were noted in mean pulmonary arterial pressure (-10%) and in pulmonary vascular resistance (-26%). Functional class improved from III to II in 9 of 11 patients. Conclusions: This trial suggests that inhaled treprostinil is safe, well tolerated, and associated with significant improvements in exercise capacity, functional class, and pulmonary hemodynamics in symptomatic patients with PAH on bosentan.

关 键 词：波生坦 肺动脉高压 TREPROSTINIL 前列环素类似物 肺血管阻力 平均肺动脉压 雾化吸入器 

分 类 号：R543[医药卫生—心血管疾病]