Efficacy and safety of Beraprost and Sildenafil in the treatment of pulmonary hypertension
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摘要: 目的:探讨贝前列素钠和西地那非治疗肺动脉高压的疗效及安全性。方法:连续入选符合标准的肺动脉高压患者44例(男7例,女37例,年龄27~69岁),随机分为贝前列素钠组(15例)、西地那非组(13例)和联合用药组(16例),分别给予贝前列素钠、西地那非单药以及二者联合治疗,治疗12周后比较3组患者治疗前后的血流动力学、6min步行距离、WHO肺动脉高压功能分级、Borg呼吸困难评分、血浆脑钠肽、血尿酸以及动脉血氧分压的变化。结果:3组患者经治疗后肺动脉收缩压、肺动脉平均压、全肺血管阻力均下降,6min步行距离增加,WHO肺动脉高压功能分级提高,Borg呼吸困难评分下降,脑钠肽、血尿酸下降,动脉血氧分压升高(P<0.05),联合治疗组疗效明显优于单独用药组(P<0.05),贝前列素钠组和西地那非组疗效差异无明显统计学意义(P>0.05)。3组药物不良反应发生率分别为20.0%、15.4%和25.0%。观察2~3周后症状逐渐消失。联合用药组不良反应发生率略高于其余2组(P<0.05)。结论:贝前列素钠联合西地那非较单独用药更能有效地降低肺动脉压力,改善血流动力学,提高运动耐力,改善临床症状。Abstract: Objective:To explore the safety and efficacy of oral beraprost sodium and sildenafil therapy for pulmonary hypertension.Method:Forty-four consecutive patients(7males and 37 females in the 27 to 69age range) with pulmonary hypertension were included in this trial.Patients were randomly assigned to 3groups:beraprost therapy group had 15cases(oral beraprost alone),sildenafil therapy group had 13cases(oral sildenafil alone) and combination therapy group had 16cases(oral beraprost and sildenafil).After 12 weeks of treatment,compared the three groups of patients before and after treatment regarding to measurement in hemodynamic parameters changement,six-minute walk test,World Health Organization-functional class,Borg dyspnoea scale,brain natriuretic peptide,serum uric acid and partial pressure of oxygen.Result:After 12 weeks,the three patient groups all had lower values in pulmonary artery systolic pressure,mean pulmonary arterial pressure,pulmonary vascular resistance,Borg dyspnoea scale,BNP and SUA,while WHO-FC,6MWD and PaO2 values increased.The combination therapy group was significantly better than the single drug therapy group.There were no significant differences between using beraprost and sildenafil.The incidence of adverse drug reaction for the above three groups were 20.0%,15.4% and 25.0% separately.The adverse drug reactions gradually alleviate after 2-3weeks.The combination therapy group had slightly higher chance of reacting to drugs adversely compared to the other two groups.Conclusion:Beraprost sodium combined with sildenafil was more effective in reducing pulmonary arterial pressure,improving hemodynamics ameliorating clinical symptoms and increasing exercise endurance.
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Key words:
- pulmonary hypertension /
- Beraprost /
- Sildenafil
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