波生坦联合他达拉非治疗肺动脉高压的疗效分析  

Curative effect of Bosentan and Tadalafil in treatment of pulmonary arterial hypertension

作　　者：张向荣[1,2] 梁培强 张峰[2] 张建立 姜鹏[2] Zhang Xiangrong;Liang Peiqiang;Zhang Feng;Jiang Peng(Medical College of Shihezi University,Shihezi 832000,China;Department of Respiratory Medicine,Xinjiang Military District General Hospital,Urumqi 830000,China)

机构地区：[1]新疆石河子大学医学院,石河子832000 [2]新疆军区总医院呼吸内科,乌鲁木齐830000

出　　处：《中华肺部疾病杂志（电子版）》2018年第1期67-71,共5页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：新疆维吾尔自治区科技成果转化专项资金项目(201554145)

摘　　要：目的探讨内皮素-1受体拮抗剂波生坦联合磷酸二酯酶-5抑制剂他达拉非治疗肺动脉高压的临床疗效。方法对2012年6月至2017年4月期间到我院呼吸科就诊的肺动脉高压患者进行筛选,符合入组标准的患者26例,其中男性10例,女性16例,平均年龄(43.27±13.93)岁;均予以波生坦+他达拉非联合治疗3个月,分别记录患者基线及治疗3个月后的WHO肺动脉高压功能分级(WHO FC)、6 min步行距离(6 MWD)、Borg呼吸困难评分、超声心动图评价指标及总胆红素、NT-proBNP、血尿酸、转氨酶等理化指标;比较治疗前后各项指标的变化。结果波生坦联合他达拉非治疗3个月后,患者的WHO肺动脉高压功能分级、6 MWD、呼吸困难Borg评分、肺动脉收缩压(PASP)与基线相比有显著改善(P<0.01),伴有心包积液的患者由基线时的11例减少至3例(P<0.05);同时总胆红素、NT-proBNP、血尿酸指标较前改善,差异具有统计学意义(P<0.01);而右心房面积、右室流出道、转氨酶较治疗前无明显变化(P>0.05)。无患者因不能耐受不良反应而改变治疗方案。结论波生坦联合他达拉非治疗肺动脉高压可以降低肺动脉压力,改善患者功能分级,提高运动耐力,两药联用可能会改善肺动脉高压患者的预后,且用药相对安全。Objective To observe the effect of combination therapy with bosentan and tadalafil on patients with pulmonary arterial hypertension(PAH).Methods A total of 26 PAH patients including 10 males and 16 females aged(43.27±13.93)years old in our hospital were recruited from June 2012 to April 2017.All patients were given combination therapy with bosentan and tadalafil,and WHO classifications of pulmonary hypertension(WHO FC),6 minutes walk distance(6 MWD),Borg dyspnea score,echocardiographic evaluation indexes and physicochemical indexes(total bilirubin,NT-proBNP,serum uric acid and transaminase)were assessed before and after 3-month treatment.Results After 3-month treatment of bosentan plus tadalafil,WHO FC,6MWD,Borg dyspnea score,pulmonary artery systolic pressure(PASP)and physicochemical indexes(total bilirubin,NT-proBNP and serum uric acid)were significantly improved(P<0.01).And the number of patients with pericardial effusion decreased from 11 to 3(P<0.05).While the right atrium area,right ventricular outflow tract and transaminase did not show obvious difference(P>0.05).And there was no patient change their therapy for safety consideration.Conclusion bosentan plus tadalafil is effective in the treatment of PAH by reducing PASP and improving WHO functional class and exercise capacity.And this combination therapy may improve the prognosis of patients with PAH and is relatively safe.

关 键 词：肺动脉高压 波生坦 他达拉非 肺动脉收缩压 6分钟步行距离 

分 类 号：R563[医药卫生—呼吸系统]