前列腺素E1对肺心病并心力衰竭患者肺动脉压及心功能的影响

Effect of Prostaglandin E1 on Pulmonary Artery Pressure and Heart Failure Patients Cardiac Function in Patients with Pneumocardial Disease Complicated Cardiac Failure

关键词:  前列腺素E1  肺心病  心力衰竭  超声心动图  脑钠肽  内皮素

Key words:  prostaglandin E1  pulmonary heart disease  heart failure  echocardiography  brain natriuretic peptide  endothelin-1

摘要:

目的 观察前列腺素E1(PGE1)对肺心病并心力衰竭患者肺动脉血流动力学参数、血浆脑钠肽及内皮素的影响。方法 将80例肺心病患者随机分为2组，对照组予利尿、强心、抗感染、纠正内环境紊乱等传统治疗，治疗组在传统治疗基础上给予PGE1静滴，疗程10 d。比较治疗前后2组患者心率(HR)、呼吸频率(R)、收缩压(SBP)、舒张压(DMP)、尿量(UV)的临床指标，肺动脉收缩压(SPAP)、肺动脉平均压(MPAP)、肺动脉舒张压(DPAP)、左室射血分数(LVEF)及心输出量(CO)的心脏超声检查结果，动脉血氧分压、二氧化碳分压[p(CO₂)]、血浆BNP、内皮素-1(ET-1)的实验室指标间的区别。结果 治疗后，2组UV明显增多，SPAP、MPAP、DPAP、BNP和ET-1明显降低，治疗组与对照组比较，差异有统计学意义(P>0.05)。结论 PGE1对肺心病心力衰竭患者有显著疗效，能显著降低肺动脉压力，改善心力衰竭，可保护血管内皮功能及降低BNP值。

Abstract:

OBJECTIVE To evaluate clinical therapeutic effects of prostagland in E1(PGE1) on hemodynamics and plasma BNP, ET-1 in cor pulmonale with heart failure and pulmonary hypertension. METHODS Eighty patients with cor pulmonale were randomly divided into treatment group(n=40, PGE1, 10 days, iv drip add conventional therapy including diuretic, enhancing myocardial contractility, anti-infection, correction of electrolyte and acid-base balance) and control group(n=40, conventional therapy). The changes of clinical manifestation such as heart rate(HR), respiratory rate(R), systolic blood pressure (SBP), diastolic blood pressure(DMP), urine output(UV), cardiac ultrasound results, arterial partial pressure of oxygen[p(O₂)], carbon dioxide partial pressure[p(CO₂)], plasma BNP, endothelin-1(ET-1) were measured before and after treatment. RESULTS After treatment, UV was significantly increased, SPAP, MPAP, DPAP, BNP and ET-1 were decreased. Compared with control group, there was significant difference in treatment group. CONCLUSION PGE1 on cor pulmonale with heart failure have significant effects, can significantly reduce pulmonary artery pressure, improve heart failure, may protect vascular endothelial function and reduce the level of BNP.