摘要
目的探讨利奥西呱联合一氧化氮(NO)对肺动脉高压患者血浆NO水平和血流动力学的影响。方法选择2016年1月~2016年12月于安康市中医医院心内科收治的182例肺动脉高压患者,随机分为对照组和试验组,每组各91例。对照组患者给予利奥西呱治疗,试验组患者给予利奥西呱联合NO吸入治疗,两组均治疗3个月。治疗前及治疗3个月后用酶联免疫吸附试验(ELSIA)测定两组血浆NO含量,以及采用右心导管检测测量并比较两组患者治疗前后右心房平均压(mRAP)、肺动脉平均压(mPAP)、肺毛细血管楔压(PCWP)、肺血管阻力(PVR)以及混合静脉血氧饱和度(SvO_2)的血流动力学指标。同时,观察并比较两组患者治疗期间不良反应的发生情况。结果治疗后,试验组患者的总有效率为94.50%,明显高于对照组的78.02%,试验组血浆NO浓度(42.51±11.97)μmol/L比对照组血浆浓度(30.41±5.19)μmol/L显著提高,差异具有统计学意义(P<0.01);治疗后,两组患者的mRAP、mPAP、PVR均明显低于治疗前,且试验组患者的mRAP、mPAP、PVR均明显低于对照组,差异均具有统计学意义(P<0.05),试验组的PCWP、SvO_2明显高于对照组,差异有统计学意义(P<0.05);治疗期间,两组患者的不良反应发生率无统计学差异(P>0.05)。结论利奥西呱联合NO吸入治疗肺动脉高压能快速纠正患者的临床症状和体征,提高血浆NO水平,有效降低肺动脉平均压和血管阻力,提高血氧饱和度,且治疗方法简单,值得在临床上推广。
Objective The aim of this study was to investigate the effect of Riociguat combined with nitric oxide on plasma NO level and hemodynamics in patients with pulmonary hypertension.Method 182 patients with pulmonary hypertension enrolled from January 2016 to December 2016 were randomly divided into control group and test group.Each group had 91 patients.Patients in the control group were treated with Riociguat,and the patients in the trial group were treated with Riociguat combined with nitric oxide.Both groups were treated for 3 months.The plasma NO levels measured by enzyme-linked immunosorbent assay(ELSIA),right atrial mean pressure(mRAP),pulmonary artery means pressure(mPAP),pulmonary capillary wedge pressure(PCWP),pulmonary vascular resistance(PVR)were compared between two groups before and after treatment.The adverse reactions during the treatment were compared between two groups.Results The total effective rate was 94.50%in the experimental group,which was significantly higher than 78.02%of the control group(χ2=10.43,P<0.01).The plasma concentration of NO(42.51±11.97)μmol/L in the experimental group was significantly higher than that in the control group(30.41±5.19)μmol/L.The mRAP,mPAP and PVR of the two groups were significantly lower than those before treatment.The mRAP,mPAP and PVR of the patients in the experimental group were significantly lower than those in the control group(P<0.05).The PCWP and SvO2 were significantly higher than those in the control group.There was no significant difference of the incidence of adverse reactions between the two groups(χ2=0.26,P>0.05).Conclusion Riociguat combined with nitric oxide inhalation in the treatment of pulmonary hypertension can quickly correct the clinical symptoms and signs of patients,improve plasma NO level,effectively reduce the average pulmonary pressure and vascular resistance,improve blood oxygen saturation,and this combination is worthy of clinical application.
作者
李伟
李芸
张伟
Li Wei;Li Yun;Zhang Wei(Department of Internal Medicine-Cardiovascular,Ankang City Hospital of traditional Chinese Medicine,Ankang 725000,China)
出处
《中国循证心血管医学杂志》
2018年第9期1125-1127,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
