他达拉非联合波生坦治疗先天性心脏病手术后肺动脉高压患者的临床效果及心功能变化  

Clinical effect and changes of cardiac function in patients with pulmonary hypertension after operation of congenital heart disease applicating tadalafil combined with bosentan

作　　者：郭建洲[1] 马琰琰[1] 王志伟[1] GUO Jian-zhou;MA Yan-yan;WANG Zhi-wei(Department of Surgery,Sun Yat-sen Cardiovascular Hospital,Shenzhen,Guangdong 518020,China)

机构地区：[1]深圳市孙逸仙心血管医院外三科,广东深圳518020

出　　处：《岭南心血管病杂志》2018年第1期40-42,82,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨他达拉非联合波生坦治疗先天性心脏病手术后肺动脉高压患者的临床价值。方法选取深圳市孙逸仙心血管医院2015年1月至2016年3月先天性心脏病手术后肺动脉高压患者86例为研究对象,经随机数字表法分为观察组与对照组,每组43例。对照组给予波生坦治疗,观察组在对照组基础上加用他达拉非治疗。观察两组治疗效果、心功能变化及不良反应发生情况。结果观察组治疗总有效率显著高于对照组,差异有统计学意义(95.35%vs.81.40%,P<0.05)。两组治疗前心功能指标比较,差异无统计学意义(P>0.05);治疗后两组均有改善。观察组治疗后左心室射血分数(LVEF)明显高于对照组,左心室舒张末期内径(LVEDD)、血浆N末端脑钠肽前体(NT-proBNP)浓度明显低于对照组,差异有统计学意义(P<0.05)。观察组与对照组用药后不良反应发生率比较,差异无统计学意义(4.65%vs.9.30%,P>0.05);未见严重不良反应。结论先天性心脏病术后肺动脉高压患者接受他达拉非联合波生坦治疗,可有效降低肺动脉压,改善心功能,且安全性高,值得推广。Objectives To probe into the clinical value of tadalafil combined with bosentan in patients with pulmonary hypertension after operation of congenital heart disease.Methods Totally86patients with pulmonary hypertension after congenital heart disease surgery in Sun Yat-sen Cardiovascular Hospital from January2015to March2016were selected,and were randomly divided into observation group and control group by the random number table method,with43cases in each group.In control group,patients were given bosentan treatment,while in observation group,on the basis of the treatment in control group,patients were treated with the tadalafil.Treatment effect,cardiac function and adverse reaction of the two groups were observed and compared.Results Total effective rate in observation group was significantly higher than that in control group(95.35%vs.81.40%,P<0.05).There was no significant difference on cardiac function before treatment between the two groups(P>0.05);after treatment,cardiac function of the two groups significantly improved.Left ventricular ejection fraction(LVEF)in observation group was significantly higher than that in control group,but left ventricular end diastolic diameter(LVEDD)and serum concentration of N-terminal pro-brain natriuretic peptide(NT-proBNP)were significantly lower than those in control group,the differences were statistically significant(P<0.05).Incidence of adverse reactions was not statistically significant between observation group and control group(4.65%vs.9.30%,P>0.05),and there was no serious adverse reactions.Conclusions Treatment of tadalafil combined with bosentan in patients with pulmonary hypertension after operation of congenital heart disease can effectively reduce pulmonary artery pressure,improve heart function with high security,thus it is worth promoting.

关 键 词：心脏缺损 先天性 肺动脉高压 波生坦 他达拉非 心功能 

分 类 号：R541.7[医药卫生—心血管疾病]