分析枸橼酸西地那非与米力农联合机械通气在新生儿持续性肺动脉高压治疗中的应用效果  

Analysis of the application effect of mechanical ventilation with sildenafil citrate and milrinone in the treatment of persistent pulmonary hypertension in newborns

作　　者：陶华 王丽 TAO Hua;WANG Li(Pediatric Department,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院儿内科,276400

出　　处：《中国实用医药》2024年第20期1-5,共5页China Practical Medicine

摘　　要：目的分析新生儿持续性肺动脉高压应用枸橼酸西地那非与米力农联合机械通气治疗的临床效果。方法选取48例持续性肺动脉高压新生患儿为观察对象,入组后以治疗模式差异将患儿分为西地那非组和米力农组,每组24例。西地那非组实行枸橼酸西地那非联合机械通气治疗,米力农组实行米力农联合机械通气治疗。比较两组临床疗效、心功能指标、血气分析指标、血清因子、肺动脉收缩压(SPAP)、体循环压改善情况。结果西地那非组临床治疗总有效率(95.83%)高于米力农组(75.00%)(P<0.05);治疗后,西地那非组右室射血分数(RVEF)(47.82±9.18)%、二尖瓣口舒张早期血流速度峰值(E值)(48.54±9.27)cm/s高于米力农组的(42.24±4.86)%、(43.46±3.73)cm/s,二尖瓣口舒张晚期血流速度峰值(A值)(41.16±3.59)cm/s低于米力农组的(43.81±4.07)cm/s(P<0.05);西地那非组动脉血二氧化碳分压(PaCO_(2))(34.42±3.18)mm Hg(1 mm Hg=0.133 kPa)、吸氧浓度(FiO_(2))(58.54±5.27)%均低于米力农组的(40.24±4.86)mm Hg、(64.66±6.73)%,血氧饱和度(SaO_(2))(93.78±5.42)%、血氧分压(PaO_(2))(84.08±6.86)mm Hg均高于米力农组的(87.16±4.98)%、(76.96±5.63)mm Hg(P<0.05);西地那非组C反应蛋白(CRP)(6.46±1.18)mg/L、基质金属蛋白酶-9(MMP-9)(36.44±2.22)mg/L、B型钠尿肽(BNP)(260.31±15.45)pg/ml均低于米力农组的(8.83±1.58)mg/L、(42.80±3.06)mg/L、(322.82±19.14)pg/ml(P<0.05);西地那非组SPAP水平(28.71±2.41)mm Hg低于米力农组的(35.94±3.56)mm Hg(P<0.05);治疗后,西地那非组收缩压(57.04±3.56)mm Hg、舒张压(40.54±1.07)mm Hg均高于米力农组的(55.17±2.61)、(39.62±1.73)mm Hg(P<0.05)。结论将枸橼酸西地那非联合机械通气治疗方案引入持续性肺动脉高压新生患儿中,疗效显著,可有效改善患儿的心功能、血气分析与血清因子水平,促进SPAP恢复正常,具有临床实践价值。Objective To analyze the clinical effect of mechanical ventilation with sildenafil citrate and milrinone in the treatment of persistent pulmonary hypertension in newborns.Methods A study was conducted on 48 newborns with persistent pulmonary hypertension.After enrollment,the children were divided into sildenafil group and milrinone group based on differences in treatment modes,each with 24 cases.Sildenafil group received mechanical ventilation with sildenafil citrate,and milrinone group received mechanical ventilation with milrinone.The clinical efficacy,cardiac function indicators,blood gas analysis indicators,serum factors,systolic pulmonary artery pressure(SPAP),and improvement in systemic circulation pressure between the two groups.Results The total effective rate of clinical treatment in sildenafil group(95.83%)was higher than that in milrinone group(75.00%)(P<0.05).After treatment,the right ventricular ejection fraction(RVEF)and early diastolic peak velocity(E value)were(47.82±9.18)%and(48.54±9.27)cm/s in sildenafil group,which were higher than(42.24±4.86)%and(43.46±3.73)cm/s in milrinone group;the late diastolic peak velocity(A value)in sildenafil group was(41.16±3.59)cm/s was lower than(43.81±4.07)cm/s in milinone group(P<0.05).In sildenafil group,the arterial partial pressure of carbon dioxide(PaCO_(2))was(34.42±3.18)mm Hg(1 mm Hg=0.133 kPa)and the inspired oxygen fraction(FiO_(2))was(58.54±5.27)%,which were lower than(40.24±4.86)mm Hg and(64.66±6.73)%in milrinone group;the blood oxygen saturation(SaO_(2))was(93.78±5.42)%and the arterial partial pressure of oxygen(PaO_(2))was(84.08±6.86)mm Hg,which were higher than(87.16±4.98)%and(76.96±5.63)mm Hg in milinone group(P<0.05).In sildenafil group,the C-reactive protein(CRP)was(6.46±1.18)mg/L,the matrix metalloproteinase-9(MMP-9)was(36.44±2.22)mg/L,and the B-type natriuretic peptide(BNP)was(260.31±15.45)pg/ml,which were lower than(8.83±1.58)mg/L,(42.80±3.06)mg/L,and(322.82±19.14)pg/ml in milineone group(P<0.05).The level of SPAP of(28.71±

关 键 词：枸橼酸西地那非 米力农 机械通气 新生儿 肺动脉高压 

分 类 号：R722.1[医药卫生—儿科]