引用本文:胡耀武,钱海燕,胡小莹,刘慧德.前列地尔联合疏血通治疗慢性阻塞性肺病合并肺动脉高压的疗效观察[J].中国临床新医学,2019,12(1):73-76.
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前列地尔联合疏血通治疗慢性阻塞性肺病合并肺动脉高压的疗效观察
胡耀武,钱海燕,胡小莹,刘慧德
735300 甘肃,酒泉市金塔县人民医院心血管内科
摘要:
[摘要] 目的 观察应用前列地尔联合疏血通治疗慢性阻塞性肺病(COPD)合并肺动脉高压(PH)患者的临床疗效。方法 选择该院2016-01~2017-02收治的COPD合并PH患者172例,随机分为对照组和研究A组、B组、C组,各43例。各组均进行常规治疗,研究A组在对照组基础上加用前列地尔治疗,研究B组加用疏血通治疗,研究C组加用前列地尔联合疏血通治疗。治疗前及治疗2周后,评估各组患者肺功能、肺动脉平均压(mPAP),检测血清内皮素-1(ET-1)、一氧化氮(NO)、纤维蛋白原(FIB)和D-二聚体(DD)水平,评估临床疗效。结果 研究C组治疗后第1秒用力呼气量(FEV1)/用力肺活量(FVC)(%)为(64.86±1.16)%,St·George呼吸疾病问卷(SGRQ)评分为(79.27±4.09)分,高于其他三组(P<0.05)。研究C组治疗后mPAP为(30.15±1.88)mmHg,低于其他三组(P<0.05)。研究C组治疗后血ET-1为(51.70±7.14)ng/L,FIB为(3.51±0.37)g/L,DD为(140.35±9.67)mg/L,均低于其他三组(P<0.05)。研究C组治疗后血NO浓度为(40.56±3.71)μml/L,高于其他三组(P<0.05)。结论 前列地尔联合疏血通治疗COPD合并PH患者能够显著改善患者肺功能,降低肺动脉压,改善患者血管内皮细胞及高凝状况,临床疗效显著。
关键词:  前列地尔  疏血通  慢性阻塞性肺病  肺动脉高压  肺功能
DOI:10.3969/j.issn.1674-3806.2019.01.20
分类号:R 563
基金项目:
Clinical effect of alprostadil combined with Shuxuetong on chronic obstructive pulmonary disease complicated with pulmonary hypertension
HU Yao-wu, QIAN Hai-Yan, HU Xiao-ying, et al.
Department of Cardiovascular Medicine, the People′s Hospital of Jinta County, Jiuquan City, Gansu 735300, China
Abstract:
[Abstract] Objective To explore the clinical effect of alprostadil combined with Shuxuetong on chronic obstructive pulmonary disease(COPD) complicated with pulmonary hypertension(PH). Methods One hundred and seventy-two patients with COPD complicated with PH were selected and were randomly divided into control group, group A, group B and group C, with 43 cases in each group. All of the groups were given conventional treatment. Group A was treated with alprostadil. Group B was treated with Shuxuetong, and group C was treated with alprostadil plus Shuxuetong. The levels of serum endothelin-1(ET-1), nitric oxide(NO), fibrinogen(FIB) and D-dimer(DD) were detected before treatment and 2 weeks after treatment, and the pulmonary function, average pulmonary artery pressure(mPAP) and clinical effects were assessed. Results The FEV1/FVC(%)[(64.86±1.16)%] and SGRQ scores[(79.27±4.09)points] in group C were significantly higher than those in the other 3 groups(P<0.05). The mPAP of group C[(30.15±1.88)mmHg] was lower than those of the other 3 groups(P<0.05). After treatment, the levels of ET-1[(51.70±7.14)ng/L], FIB[(3.51±0.37)g/L], and DD[(140.35±9.67)mg/L] in group C were lower than those in the other 3 groups(P<0.05). After treatment, the concentration of blood NO in group C[(40.56±3.71)μmol/L] was higher than those in the other 3 groups(P<0.05). Conclusion Alprostadil combined with Shuxuetong can significantly improve the lung function, reduce the pulmonary arterial pressure, and improve the endothelium cell and coagulation status in the patients with COPD complicated with PH.
Key words:  Alprostadil  Shuxuetong  Chronic obstructive pulmonary disease(COPD)  Pulmonary hypertension(PH)  Pulmonary function