摘要
目的分析西地那非治疗西藏极高海拔地区婴幼儿中重度肺动脉高压的效果和安全性。方法选择2018年10至2019年6月收治的40例极高海拔地区中重度肺动脉高压患儿作为研究对象,按抽信封法分为研究组[20例,常规强心、利尿、扩血管治疗+口服西地那非1~1.5 mg/(kg·d)]和对照组(20例,常规强心、利尿、扩血管治疗)。比较两组患儿治疗前、后的各项指标。结果治疗后,研究组的心率、呼吸频率、经皮血氧饱和度、肺动脉压、下腔静脉直径、下腔静脉塌陷率、右心室横径、总胆红素水平均优于对照组及治疗前,差异具有统计学意义(P<0.05)。治疗前、后,研究组的血常规指标(白细胞、红细胞、血小板)、生化指标(谷草转氨酶、谷丙转氨酶、磷酸肌酸激酶、肌酸激酶同工酶、尿素氮、肌酐)及左心室功能指标[左心室射血分数(LVEF)、左室短轴缩短指数(FS)]比较,差异均无统计学意义(P>0.05)。研究组治疗过程中未见荨麻疹、呕吐、腹泻、低血压、肝损害、心肌损害、肾损害等不良反应。结论小剂量西地那非能有效降低西藏极高海拔地区婴幼儿中重度肺动脉高压肺,改善患儿的右心功能,且安全性较高,在医疗资源匮乏的高原地区值得推广。
Objective To analyze the efficacy and safety of sildenafil in the treatment of infants with moderate and severe pulmonary hypertension in extremely high altitude area of Tibet.Methods From October 2018 to June 2019,40 children with moderate and severe pulmonary hypertension in extremely high altitude area were selected as the study objects and divided into study group[20 cases,routine cardiotonic,diuretic and vasodilator therapy+oral sildenafil 1~1.5 mg/(kg·d)]and control group(20 cases,routine cardiotonic,diuretic and vasodilator therapy)according to envelope drawing method.The indexes of the two groups before and after treatment were compared.Results After treatment,the heart rate,respiratory rate,transcutaneous oxygen saturation,pulmonary artery pressure,inferior vena cava diameter,inferior vena cava collapse rate,right ventricular diameter and total bilirubin level in the study group were better than those in the control group and before treatment,and the differences were statistically significant(P<0.05).Before and after treatment,there were no significant differences in blood routine indexs(white blood cells,red blood cells,platelets),biochemical indexs(glutamic oxaloacetylase,glutamic pyruvic transaminase,creatine phosphokinase,creatine kinase isoenzyme,urea nitrogen,creatinine)and left ventricular function indexs[left ventricular ejection fraction(LVEF),left ventricular short axis shortening index(FS)]between the two groups(P>0.05).There were no adverse reactions such as urticaria,vomiting,diarrhea,hypotension,liver damage,myocardial damage and kidney damage in the therapy process of the study group.Conclusion Low dose sildenafil can effectively reduce the pulmonary hypertension of infants in Tibet,improve the right heart function,and has high security.It is worth popularizing in the plateau area where medical resources are scarce.
作者
章玉丹
文俊
德吉措姆
苏宇飞
贡觉吾金
胡海霞
洛桑群培
ZHANG Yu-dan;WEN Jun;Deji Cuomu;SU Yu-fei;Gongjue Wujin;HU Hai-xia;Luosang Qunpei(Emergency Department,Xi'an Children's Hospital,Xi'an 710003;Pediatrics Department,Ngari People's Hospital,Ngari 859000,China)
出处
《临床医学研究与实践》
2020年第13期101-103,共3页
Clinical Research and Practice
关键词
西地那非
肺动脉高压
心功能
极高海拔地区
血常规指标
生化指标
sildenafil
pulmonary hypertension
heart function
extremely high altitude area
blood routine index
biochemical index
