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|本期目录/Table of Contents|

艾森曼格综合征肺动脉高压靶向治疗效果观察

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2016年第2期
页码:
166-169
栏目:
临床研究
出版日期:
2015-11-25

文章信息/Info

Title:
Clinical efficacy of targeted therapy for patients with Eisenmenger syndrome
作者:
薛建颖; 张玉顺; 成革胜; 杜亚娟; 何 璐; 王星晔
(西安交通大学第一附属医院心内二科，陕西 西安 710061)
Author(s):
XUE Jian-ying;  ZHANG Yu-shun;  CHENG Ge-sheng;  DU Ya-juan;  HE Lu;  WANG Xing-ye
(Second Department of Cardiology, First Affiliated Hospital, Medical College, Xi’an Jiaotong University, Xi’an 710061, Shaanxi, China)
关键词:
艾森曼格综合征; 肺动脉高压; 心脏病; 先天性; 靶向药物
Keywords:
Eisenmenger syndrome;  pulmonary arterial hypertension;  congenital heart disease;  targeted therapy
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的 观察肺动脉高压靶向药物治疗对艾森曼格综合征的临床效果。方法 选择艾森曼格综合征患者36例，年龄9~51（39±18）岁。其中房间隔缺损（ASD）11例、室间隔缺损（VSD）14例、动脉导管未闭（PDA）6例、VSD+PDA 3例、ASD+PDA 2例。应用波生坦或西地那非治疗，根据服药情况分为长期用药组和间断用药组，2年后评估其疗效。结果 长期用药组2年后经皮血氧饱和度(SpO2)、6 min步行距离(6MWTD)较用药前显著升高（P<0.05），Borg评分、纽约心脏病学会心功能分级(NYHA)、脑钠尿肽(BNP)、肺动脉收缩压(sPAP)较用药前显著减低（P<0.05）。与用药前相比，肺循环血流量 /体循环血流量(Qp/Qs)显著升高（P<0.05），肺动脉平均压(mPAP)、肺动脉收缩压/体循环收缩压(Pp/Ps)显著减低（P<0.05）； 肺血管阻力(PVR)也有不同程度降低，但差异无统计学意义。间断用药组SpO2、6MWTD较用药前亦显著升高（P<0.05），BNP较用药前显著减低（P<0.05）；Borg评分、NYHA、sPAP虽有不同程度改善，但差异无统计学意义。长期用药组与间断用药组相比，6MWTD、Borg评分、NYHA、BNP、sPAP等指标均无明显差异。但长期用药组SpO2显著升高（P<0.05）。结论 间断靶向治疗可用于部分艾森曼格综合征患者。
Abstract:
AIM To observe the clinical efficacy of targeted therapy for patients with Eisenmenger syndrome (ES). METHODS A total of 36 ES patients aged 9 to 51 years ［mean (38.6±17.7) years］, among whom 24 were females, were evaluated. Among the patients, 14 had ventricular septal defect (VSD), 11 had atrial septal defect (ASD), six had patent ductus arteriosus (PDA), three had VSD+PDA, and two had ASD+PDA. According to the treatment regimens, patients treated with bosentan or sildenafil were divided into long-term therapy group (regular medication for 2 years) and intermittent therapy group (cumulative medication for 6 months). Efficacy of the therapy was evaluated after the 2-year treatment. RESULTS Compared with those pre-treatment, SpO2 and the 6-min walking test (6MWT) distance in the long-term therapy group increased significantly (P<0.05). Borg score, NYHA-FC, BNP and sPAP decreased obviously (P<0.05) after treatment. Compared with those pre-treatment, Qp/Qs in the long-term therapy group increased significantly (P<0.05), and mPAP and Pp/Ps decreased obviously (P<0.05). PVR also decreased but showed no significant difference. Compared with those pre-treatment, SpO2 and 6MWT distance in intermittent therapy group increased (P<0.05). BNP decreased obviously (P<0.05). Borg score and NYHA-FC and sPAP also decreased but showed no significant difference. Although no significant difference was found in the 6MWT distance, Borg score, NYHA-FC, BNP and sPAP between groups, SpO2 in long-term therapy group increased obviously (P<0.05). CONCLUSION Intermittent targeted therapy could partially benefit patients with ES.

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备注/Memo

备注/Memo:
收稿日期：2015-05-04.
通讯作者：张玉顺，教授，主要从事结构性心脏病的介入诊断与治疗 Email:zys2889@sina.com
作者简介：薛建颖，硕士生 Email：xjy_1983@sohu.com
更新日期/Last Update: 2016-04-25