安立生坦联合西地那非治疗肺动脉高压的效果及对肺动脉压力、运动耐力的影响  

Effect of combination therapy of ambrisentan and sildenafil on pulmonary arterial hypertension and its impact on pulmonary arterial pressure and exercise endurance

作　　者：王亚 王倩 Wang Ya;Wang Qian(Department of Cardiology,The Third People's Hospital of Chengdu,Chengdu 610000,China)

机构地区：[1]四川省成都市第三人民医院心内科,成都610000

出　　处：《中国综合临床》2025年第1期37-43,共7页Clinical Medicine of China

摘　　要：目的探讨安立生坦联合西地那非治疗肺动脉高压(pulmonary arterial hypertension,PH)的效果及对肺动脉压力、运动耐力的影响。方法回顾性分析2021年8月至2023年8月就诊于成都市第三人民医院心内科就诊的156例PH患者的临床资料,根据1∶1组间基线特征匹配的原则分为观察组和对照组,每组各78例。对照组采用西地那非治疗,观察组采用安立生坦联合西地那非治疗。比较两组患者的临床疗效和治疗期间不良反应发生情况。对比分析两组患者治疗前和治疗1个月后的肺动脉压力[平均肺动脉压(mean pulmonary artery pressure,mPAP)、肺动脉楔压(pulmonary artery wedge pressure,PAWP)、肺血管阻力(pulmonary vascular resistance,PVR)、心脏指数]、动脉血气指标[氧分压、二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))、氧饱和度]、血清生化指标[N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-pro BNP)、内皮素1]和运动耐力[6 min步行距离(6 min walking distance,6MWD)]水平。符合正态分布的计量资料组间比较采用t检验;计数资料计算百分率,组间比较采用χ^(2)检验。结果观察组患者的总有效率(98.7%,77/78)显著高于对照组(91.0%,71/78),差异有统计学意义(χ^(2)=4.74,P=0.029);两组的不良反应发生率比较差异无统计学意义(P>0.05)。治疗1个月后,观察组和对照组患者的mPAP[(46.01±7.23)、(48.58±8.34)mmHg)]、PAWP[(9.53±1.01)、10.14±1.17)mmHg]、PVR[(9.28±1.41)、10.04±1.33)Wood单位)]、PaCO_(2)[(39.89±5.26)、43.35±4.73)mmHg]、NT-pro BNP[(427.78±85.05)、(513.14±114.53)ng/L]和内皮素1[(55.10±8.37)、(66.01±9.78)μg/L]较治疗前[(62.21±10.63)、(61.89±11.07)mmHg,(10.86±1.49)、(11.19±1.50)mmHg,(12.02±1.57)、(11.69±1.70)Wood单位,(55.99±6.10)、(56.22±5.87)mmHg,(1408.32±513.98)、(1400.89±524.14)ng/L,(89.03±9.79)、(87.88±11.24)μg/L]显著降低,差异均有统计学意义(t值分别为16.02、12.11、9.40、6.95、16.Objective To investigate the efficacy of combination therapy of ambrisentan and sildenafil in the treatment of pulmonary arterial hypertension(PH)and its effects on pulmonary arterial pressure and exercise endurance.MethodsA retrospective analysis was conducted on the clinical data of 156 patients with PH who visited the Department of Cardiology at the Third People's Hospital of Chengdu from August 2021 to August 2023.According to the principle of 1∶1 baseline feature matching between groups,they were divided into an observation group and a control group,with 78 patients in each group.The control group was treated with sildenafil,while the observation group was treated with combination therapy of anlisentan and sildenafil.Compare the clinical efficacy and incidence of adverse reactions during treatment between two groups of patients.Compare the pulmonary artery pressure(mean pulmonary artery pressure(mPAP),pulmonary artery wedge pressure(PAWP),pulmonary vascular resistance(PVR),heart index),arterial blood gas indicators(oxygen partial pressure,partial pressure of carbon dioxide(PaCO_(2)),oxygen saturation),serum biochemical indicators(N-terminal pro brain natriuretic peptide(NT pro BNP),endothelin 1),and exercise tolerance between two groups of patients before and after one month of treatment.Strength(6-minute walking distance,6MWD)level.The t-test was used for inter group comparison of metric data that conforms to normal distribution,the percentage was calculated for count data,and the chi square test is used for inter group comparison.ResultsThe total effective rate of the observation group(98.7%,77/78)was significantly higher than that of the control group(91.0%,71/78),and the difference was statistically significant(χ^(2)=4.74,P=0.029);There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).After 1 month of treatment,the mPAP((46.01±7.23),(48.58±8.34)mmHg),PAWP((9.53±1.01),(10.14±1.17)mmHg),PVR((9.28±1.41),(10.04±1.33)Wood),PaCO_(2)((39.8

关 键 词：安立生坦 西地那非 肺动脉高压 肺动脉压力 运动耐力 

分 类 号：R54[医药卫生—心血管疾病]