吸入性treprostinil在重度肺动脉高压中的良好效果:来自随机对照初步研究的结果  

Favorable Effects of Inhaled Treprostinil in Severe Pulmonary Hypertension.Results From Randomized Controlled Pilot Studies

作　　者：Voswinckel R. Enke B. Reichenberger F. H.Olschewski 郭俊 

机构地区：[1]Department of Internal Medicine,University Hospital Giessen,Giessen,Germany Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2007年第4期51-51,共1页

摘　　要：目的:本研究旨在探讨吸入性treprostinil对重度肺动脉高压患者的肺血流动力学和气体交换的作用。Objectives:This study sought to investigate the effects of inhaled treprostinil on pulmonary hemodynamics and gas exchange in severe pulmonary hypertension. Background:Inhaled iloprost therapy has a proven clinical efficacy in pulmonary arterial hypertension,but this therapy necessitates 6 to 9 inhalation sessions per day. Treprostinil has a longer plasma half-life and might provide favorable properties when applied by inhalation. Methods:Three different studies were conducted on a total of 123 patients by means of right heart catheterization:1) a randomized crossover-design study(44 patients),2) a dose escalation study(31 patients),and 3) a study of reduction of inhalation time while keeping the dose fixed(48 patients). The primary end point was the change in pulmonary vascular resistance(PVR). Results:The mean pulmonary arterial pressure of the enrolled patients was approximately 50 mm Hg in all studies. In study 1,both treprostinil and iloprost at an inhaled dose of 7.5 μg displayed a comparable PVR decrease,with a significantly different time course(p< 0.001),treprostinil showing a more sustained effect on PVR(p< 0.0001) and fewer systemic side effects. In study 2,effects of inhalation were observed for 3 h. A near-maximal acute PVR decrease was observed at 30 μg treprostinil. In study 3,treprostinil was inhaled at increasing concentrations with a pulsed ultrasonic nebulizer,mimicking a metered dose inhaler. A dose of 15 μg treprostinil was inhaled with 18,9,3,2 pulses,or 1 pulse,each mode achieving comparable,sustained pulmonary vasodilation without significant side effects. Conclusions:Inhaled treprostinil exerts sustained pulmonary vasodilation with excellent tolerability at relatively low doses and may be inhaled in a few breaths.

关 键 词：重度肺动脉高压 TREPROSTINIL 伊洛前列素 肺血管阻力 血流动力学 右心导管 气体交换 平 

分 类 号：R543.2[医药卫生—心血管疾病]