贝前列素钠、西地那非起始联合与序贯治疗慢性阻塞性肺疾病合并肺动脉高压的效果比较  

Efficacy of initial combination versus sequential therapy of berprost sodium and sildenafil in chronic obstructive pulmonary disease with pulmonary hypertension

作　　者：冼倩 庞浩文 吴旭 XIAN Qian;PANG Hao-wen;WU Xu(Department of Emerency,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)

机构地区：[1]广东医科大学附属医院急诊科,广东湛江524001

出　　处：《广东医科大学学报》2022年第4期408-411,共4页Journal of Guangdong Medical University

基　　金：湛江市科学技术局科技攻关项目(2018B01067)。

摘　　要：目的比较贝前列素钠、西地那非起始联合与序贯治疗慢性阻塞性肺疾病合并肺动脉高压(COPD-PH)的效果。方法86例COPD-PH患者随机分为贝前列素钠和西地那非起始联合组(30例)、序贯A组(先用贝前列素钠,后期添加西地那非;31例)、序贯B组(先用西地那非,后期添加贝前列素钠;25例),治疗24周。比较3组肺功能、动脉血气分析、肺动脉收缩压(PASP)、氨基末端脑钠肽前体(NT-proBNP)、6 min步行距离(6MWD)、Borg呼吸指数、不良反应等情况。结果治疗后起始联合组PASP、PaCO_(2)、NT-proBNP、Borg呼吸指数均低于序贯A、B组(P<0.01或0.05),而PaO_(2)、FEV1、FVC%、6 MWD高于序贯A、B组(P<0.01或0.05);序贯A、B两组疗效及3组不良反应差异无统计学意义(P>0.05)。结论贝前列素钠、西地那非起始联合可降低COPD-PH患者肺动脉阻力和压力、改善肺功能和运动耐力。Objective To compare the efficacy of initial combination(IC) versus sequential therapy(ST) of berprost sodium and sildenafil in chronic obstructive pulmonary disease with pulmonary hypertension(COPD-PH). Methods Eightysix COPD-PH patients were randomly treated with IC of beraprost sodium and sildenafil(IC group;n=30) and ST of first beraprost sodium(STA group;n=31) or first sildenafil(STB group;n=25) for 24 weeks. The pulmonary function, arterial blood gas, pulmonary artery systolic pressure(PASP), NT-proBNP, 6-min walking distance(6MWD), Borg respiratory index, and adverse reactions were compared among three groups. Results Compared with STA and STB groups, PASP, PaCO_(2), NTproBNP, and Borg respiratory index were lower, while PaO_(2), FEV1, FVC%, and 6 MWD were higher in IC group(P<0.01 or 0.05). There were no differences in clinical efficacy between STA and STB groups and adverse reactions among three groups(P>0.05). Conclusion The IC of beraprost sodium and sildenafil can remarkably reduce pulmonary artery resistance and pressure, and improve lung function and exercise endurance in COPD-PH patients.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 贝前列素钠 西地那非 

分 类 号：R563[医药卫生—呼吸系统]