波生坦治疗结缔组织病相关肺动脉高压临床疗效观察及安全性分析  

Clinical efficacy and safety of bosentan in treatment of connective tissue disease associated pulmonary arterial hypertension

作　　者：刘玉芳[1] 石磊[1] Liu Yufang;Shi Lei(Department of Rheumatology and Immunology, the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第二医院风湿免疫科,太原030001

出　　处：《中国药物与临床》2019年第6期867-869,共3页Chinese Remedies & Clinics

基　　金：山西省回国留学人员科研资助项目(2016-124)

摘　　要：目的观察波生坦治疗结缔组织病相关肺动脉高压(CTD-PAH)的有效性及安全性。方法分析和比较42例经波生坦治疗的CTD-PAH患者4周的6 min步行距离(6MWD),Borg呼吸困难评分,生活质量调查表评分(SF-36),肺动脉高压心功能分级及超声心动图指标较基线变化情况。结果与基线时相比,波生坦治疗4周6MWD从(328±68)m增加至(402±62)m(P<0.05)。Borg评分由(3.1±1.3)减少至(2.5±1.4)(P<0.05)。SF-36量表中除社会功能外其他7项维度评分均有改善(P<0.05)。肺动脉高压心功能分级较前改善(P<0.05)。并发心包积液由基线19例(45%)减少至8例(19%)(P<0.05)。超声心动图中左房内径、左室舒张末期内径、三尖瓣反流速率和肺动脉压力分别由基线状态时的(35±7)mm、(41±9)mm、(4.4±0.6)m/s和(63±23)mmHg减少至治疗4周后的(37±7)mm、(40±7)mm、(4.2±0.5)和(54±12)(P<0.05)。治疗组无药物不良反应发生。结论波生坦有效改善CTD-PAH患者心脏功能,是治疗CTD-PAH安全有效靶向药物。Objective To investigate the efficacy and safety of bosentan in the treatment of connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH). Methods Forty-two CTD-PAH patients treated with bosentan for four weeks were measured for changes in 6-minute walk distance (6MWD), Borg dyspnea score, quality of life questionnaire score(SF-36), heart function, pulmonary artery pressure classification and echocardiographic index from baseline. Results After the4-week treatment with bosentan and compared with baseline, the 6MWD increased from (328±68) m to (402±62) m (P<0.05);the Borg score reduced from (3.1±1.3) to (2.5±1.4)(P<0.05);the scores of the other seven domains except for social function in the SF-36 scale were improved (P<0.05);the cardiac function classification was improved (P<0.05);the numberof patients with concomitant pericardial effusion decreased from 19 (45%)at baseline to 8 (19%) after treatment(P<0.05);the left atrial diameter, left ventricular end-diastolic diameter, tricuspid regurgitation rate, and pulmonary artery pressure onechocardiography decreased from(35±7)mm,(41±9)mm,(4.4±0.6), and (63±23)mmHg at baseline to (32±7)mm,(40±7)mm,(4.2±0.5)mm, and (54±12)mmHg after treatment(P< 0.05). No adverse drug reactions occurred in the treatment group. Conclusion Bosentan may improvethe cardiac function in patients with CTD-PAH, and is effective and safe for treatment of CTD-PAH.

关 键 词：波生坦 结缔组织疾病 高血压 肺性 

分 类 号：R544.1[医药卫生—心血管疾病] R593.2[医药卫生—内科学]