期刊文献+

不同剂量西地那非治疗新生儿肺动脉高压的疗效 被引量:41

Effectiveness of Different Doses of Sildenafil on Persistent Pulmonary Hypertension of Newborns
在线阅读 下载PDF
导出
摘要 目的探讨口服不同剂量的西地那非(SIL)治疗新生儿持续性肺动脉高压(PPHN)的疗效、有效剂量和不良反应。方法 48例PPHN患儿在呼吸机机械通气下口服SIL,根据用药剂量分为3组,每6h给药1次,每次剂量分别是0.3、0.5和1.0mg/kg。治疗前和治疗后3d检测动脉氧合和肺动脉压(PAP)的变化,记录心率、血压、呕吐次数等。结果口服SIL 3d后3组患儿动脉血氧分压(PaO2)和动脉血氧饱和度(SaO2)均明显提高(均P<0.01),PAP显著下降(P<0.05或P<0.01);3组患儿在提高动脉氧合指标(PaO2、SaO2)上无显著差异,而0.3mg/kg组PAP下降程度及PPHN治疗有效率小于0.5、1.0mg/kg组(均P<0.05);治疗期间所有患儿均未出现明显不良反应。结论口服SIL在新生儿持续性肺动脉高压的治疗上有显著疗效,安全性好,有效剂量为每次0.3~1.0mg/kg,6h给药1次。 Objective To observe the effectiveness of different doses of sildenafil(SIL)on pulmonary artery pressure(PAP) and oxygenation of persistent pulmonary hypertension of newborns(PPHN). Methods Forty-eight newborns with PPHN were recruited from December 2005 to May 2011 in NICU. The patients were randomly assigned to three groups,which were given orally 0.3,0.5 and 1.0 mg/kg SIL respectively, once per 6 h for 3 days. Arterial blood gas analysis was done and PAP was meas ured before treatment and 3 days after treatment. HR,BP,and vomiting times were recorded. Results At 3rd day after adminis tration of SIL, PaO2 and SaO2 were significantly increased (P〈0.01) and PAP significantly reduced (P〈0.05 ). There was no significant difference in the oxygenation indexes(PaO2 ,SaO2)among three groups. But the decrease of PAP in 0.3 mg/kg dose SIL group was lower than in 0.5 mg/kg and 1.0 mg/kg dose SIL groups(P〈0.05). No side effects occurred in all patients treated with SIL. Conclusion SIL is an effective and safe drug to reduce PAP and improve oxygenation of PPHN. Effective doses are 0.3-1.0 mg/kg,4 times per day.
出处 《华中科技大学学报(医学版)》 CAS CSCD 北大核心 2012年第2期210-213,共4页 Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金 湖北省自然科学基金资助项目(No.2006S2099)
关键词 西地那非 持续性肺动脉高压 新生儿 sildenafil persistent pulmonary hypertension newborn
  • 相关文献

参考文献14

  • 1杜立中.新生儿持续肺动脉高压发病相关因素及治疗进展[J].中国实用妇科与产科杂志,2003,19(6):327-328. 被引量:14
  • 2Raja S G,Danton M D,Macarthur K J,et al.Treatment of pulmonary arterial hypertension with sildenafil:from pathophysiology to clinical evidence[J].J Cardiothorac Vasc Anesth,2006,20(5):722-735.
  • 3Namachivayam P,Theilen U,Butt W W,et al.Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children[J].Am J Respir Crit Care Med,2006,174(9):1042-1047.
  • 4Attino T M,Malatino L S,Maxwell S R,et al.Phosphodies-terase type 5 inhibition reverses impaired forearm exercise-induced vasodilatation in hypertensive patients[J].J Hypertens,2008,26(3):501-507.
  • 5Krishnan U.Management of pulmonary arterial hypertensi-on in the neonatal unit[J].Cardiol Rev,2010,18(2):73-75.
  • 6杜军保,石云.新生儿持续肺动脉高压[J].中国新生儿科杂志,2006,21(3):181-184. 被引量:19
  • 7Leuchte H H,Schwaiblmair M,Baumgartner R A,et al.Hem-odynamic response to sildenafil,nitric oxide,and iloprost in primary pulmonary hypertension[J].Chest 2004,125(2):580-586.
  • 8Michelakis E D,Tymchak W,Noga M,et al.Long-term treatment with oral silednafil is safe and improves functional capacity and hemodynamics in patients with pulmonary arterial hypertension[J].Circulation,2003,108(17):2066-2069.
  • 9de Visser Y P,Walther F J,Laghmaniel H,et al.Sildenafil attenuates pulmonary inflammation and fibrin deposition,mortality and right ventricular hypertrophy in neonatal hyperoxic lung injury[J].Respir Res,2009,10:30.
  • 10童凡,杜立中,施丽萍.西地那非与前列地尔治疗先天性心脏病术后肺动脉高压的疗效对比[J].中华急诊医学杂志,2006,15(11):1002-1005. 被引量:11

二级参考文献40

  • 1杨丽丽,涂文婷,王良兴,张旭,张琴辉,范小芳,徐正介.静脉注射微粒对家兔血浆TXA_2、PGI_2及肺动脉压力影响的研究[J].中华急诊医学杂志,2005,14(3):260-262. 被引量:16
  • 2杜军保,周丛乐,马郁文,李万镇.一氧化氮治疗新生儿持续肺动脉高压的现状与展望[J].新生儿科杂志,1995,10(5):195-196. 被引量:1
  • 3李万镇,杜军保,马郁文,李源,李小梅.脉冲多普勒超声心动图估测小儿肺动脉压[J].北京医科大学学报,1990,22(3):189-191. 被引量:4
  • 4Meng L K,Liu C G.Gene therapies for pulmonary hypertension-from experimental trials to bedside aspects[J].Eur J Cardio-Thorac,2010,37(2):407-419.
  • 5Rabinovitch M.Pulmonary hypertension:updating a mysterious disease[J].Cardiovas Res,1997,34(2):268-272.
  • 6Rabinovitch M,Haworth S G,Castaneda A R,et al.Lung biopsy in congenital heart disease:a morphometric approach to pulmonary vascular disease[J].Circulation,1978,58(6):1107-1122.
  • 7Rabinovitch M.Molecular pathogenesis of pulmonary arterial hypertension[J].J Clin Invest,2008,118(7):2372-2379.
  • 8Garcia R,Diebold S.Simple,rapid,and effective method of producing aortocaval shunts in the rat[J].Cardiovas Res,1990,24(5):430-432.
  • 9Everett A D,Le Cras T D,Xue C,et al.eNOS expression is not altered in pulmonary vascular remodeling due to increased pulmonary blood flow[J].Am J Physiol,1998,274(6 Pt 1):L1058-L1065.
  • 10Chou T F,Wu M S,Chien C T,et al.Enhanced expression of nitric oxide synthase in the early stage after increased pulmonary blood flow in rats[J].Eur J Cardiothorac,2002,21(2):331-336.

共引文献43

同被引文献311

引证文献41

二级引证文献221

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部