先天性心脏病并发重度肺动脉高压介入封堵联合伐地那非的应用研究

卢荔红; 关瑞锦; 吴志勇; 陈斌; 陈新敬; 蒋辉

doi:10.13201/j.issn.1001-1439.2012.07.003

先天性心脏病并发重度肺动脉高压介入封堵联合伐地那非的应用研究

- 福建医科大学省立临床医学院福建省心血管病研究所心内科(福州, 350001)

详细信息

通讯作者: 卢荔红,E-mail:lulihong168@163.com

中图分类号: R541.1

收稿日期: 2011-11-20

修回日期: 2012-01-07

Intervention and vardenafil combination therapy in congenital heart disease with severe pulmonary hyperten

- Department of Cardiology, Fujian Cardiovasular Institue, Fujian Medical University, Fuzhou, 350001, China

More Information

Corresponding author: LU Lihong, E-mail: lulihong168@163.com

Received Date: 20 November 2011

Revised Date: 07 January 2012

摘要

摘要: 目的:研究先天性心脏病(CHD)并发重度肺动脉高压(PAH)介入封堵联合盐酸伐地那非综合治疗的应用。方法:术前、后常规给予29例患者口服盐酸伐地那非治疗,对有介入封堵适应证的患者置入封堵器进行试验性封堵测压,若肺动脉压降低幅度为原来压力的20%或下降30mmHg(1mmHg=0.133kPa)以上后进行永久封堵,术后继续采用超声多普勒心动图随访患者肺动脉收缩压(SPAP)、肺循环、体循环收缩压比值(Pp/Ps)、右室大小(RV)、左室射血分数(LVEF)12个月。结果:本组29例患者经术前、后常规予盐酸伐地那非治疗后,27例行介入试验性封堵测压,随后有25例肺动脉压降低幅度为原来压力的20%或下降30mmHg以上。对这25例患者进行永久封堵,且5例使用带孔封堵器,随访12个月,除1例死亡外,其余心功能恢复Ⅰ级以上、动脉血氧饱和度(SaO₂)均恢复在0.95以上、SPAP、Pp/Ps、LVEF、RV均有显著改善(均P<0.05)。4例无法封堵的患者除1例转心外科手术后死亡外,其余心功能由Ⅳ级恢复到Ⅲ级、SaO2在0.90以上、动脉血氧分压>60mmHg。结论:介入试验性封堵联合盐酸伐地那非综合治疗微创、简便、安全、可靠,给CHD并发重度PAH的患者带来根治的希望。
- 先天性心脏病 /
- 重度肺动脉高压 /
- 介入封堵 /
- 带孔封堵器 /
- 盐酸伐地那非
Abstract: Objective:To explore the effect of interventional therapy combinated with vardenafil in congenital heart disease(CHD) with severe pulmonary hypertension(PAH). Method:Twenty-nine patients received vardenafil before and after the interventional therapy.Pulmonary systolic pressure(SPAP),the ratio of pulmonary/systemicsystolic pressure(Pp/Ps),right ventricular(RV),and left ventricular ejection fraction(LVEF) were followed by echocardiography for 12 months. Result:Twenty-nine patients received vardenafil before and after operation,which twenty-seven cases with indications of interventional therapy were measured SPAP.Twenty-five cases pulmonary artery pressure decreased 20% or 30 mmHg and underwent the interventional therapy successfully.Except one died,other patients heart function had recoveried over grade Ⅰ,arterial oxygen saturation(SaO2) had recoveried more than 0.95,SPAP,Pp/Ps,LVEF and RV had significantly improved(P<0.05).Four cases without indications of interventional therapy,except one died by surgical treatment,the others heart function had recoveried from grade Ⅳ to grade Ⅲ,arterial oxygen saturation(SaO2) had recoveried more than 0.95,arteries partial pressure of oxygen(PaO₂) >60 mmHg. Conclusion:The interventional therapy combined with vardenafil is a micro-trauma,effective and safe method for the treatment of CHD with severe PAH.
- congenital heart disease /
- severe pulmonary hypertension /
- interventional therapy /
- vardenafil /

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