本文選題：前列地爾 + 一氧化氮　； 參考：《中國藥房》2017年17期

【摘要】：目的:觀察前列地爾聯(lián)合一氧化氮對先天性心臟病合并肺動脈高壓患兒的臨床效果及免疫功能的影響。方法:采用回顧性研究方法,選取2009年8月-2015年2月我院胸心血管外科收治的40例先天性心臟病合并肺動脈高壓患兒,依據(jù)治療方式不同分為一氧化氮組(單獨組)和前列地爾+一氧化氮組(聯(lián)合組),各20例。兩組患兒均給予先天性心臟病合并肺動脈高壓的常規(guī)手術治療;單獨組患兒術后予以外源性吸入一氧化氮(體積分數(shù)為20×10-6),聯(lián)合組患兒在此基礎上聯(lián)合靜脈泵入前列地爾5 ng/(kg·min),持續(xù)72 h。比較兩組患兒治療前后的心率、左室射血分數(shù)、平均動脈壓、肺動脈壓、T淋巴細胞和免疫球蛋白(Ig)的變化,以及不良反應發(fā)生情況。結果:治療前,兩組患兒上述各項指標比較,差異均無統(tǒng)計學意義(P0.05)。治療后,兩組患兒的心率、左室射血分數(shù)、平均動脈壓、CD3~+、Ig A、Ig M和Ig G水平無明顯變化,但CD4~+、CD4~+/CD8~+、Treg/CD4~+均較治療前顯著升高,肺動脈壓、CD8~+、Th1、Th2、Th1/Th2、Th17/CD4~+、補體C3和補體C4水平均較治療前顯著下降,且聯(lián)合組上述指標均顯著優(yōu)于單獨組,差異均有統(tǒng)計學意義(P0.05)。兩組患兒均未見明顯不良反應發(fā)生。結論:前列地爾聯(lián)合一氧化氮可顯著降低先天性心臟病合并肺動脈高壓患兒的肺動脈壓,改善T淋巴細胞表達情況,降低補體C3和C4水平,且安全性較高。
[Abstract]:Aim: to observe the clinical effect and immune function of prostadil combined with nitric oxide in children with congenital heart disease complicated with pulmonary hypertension. Methods: a retrospective study was conducted on 40 children with congenital heart disease complicated with pulmonary hypertension from August 2009 to February 2015. The patients were divided into two groups: nitric oxide group (20 cases) and prostadil nitric oxide group (20 cases). Children in both groups were treated with conventional surgical treatment of congenital heart disease complicated with pulmonary hypertension. Children in the single group were given exogenous inhaled nitric oxide (volume fraction 20 脳 10 ~ (-6) after operation, and combined with intravenous infusion of alprostadil for 72 hours. The changes of heart rate, left ventricular ejection fraction, mean arterial pressure, pulmonary artery pressure T lymphocyte and immunoglobulin IgA before and after treatment were compared between the two groups. Results: before treatment, there was no significant difference in the above indexes between the two groups (P 0.05). After treatment, the heart rate, left ventricular ejection fraction (LVEF), mean arterial pressure (CD3 ~ +), Ig Ag M and IgG levels in both groups were not significantly changed, but CD4 ~ + / CD4 ~ / CD8 ~ / CD8 ~ + Treg-CD4 ~ were significantly higher than those before treatment, and pulmonary artery pressure was significantly higher than that before treatment, and the pulmonary artery pressure (PPA) was CD8 ~ + Th1Th2Th2Th2Th1 / Th2Th17 / CD4 ~. The levels of complement C3 and complement C4 were significantly lower than those before treatment, and the above indexes in the combined group were significantly better than those in the single group, and the differences were statistically significant (P 0.05). No significant adverse reactions occurred in both groups. Conclusion: prostadil combined with nitric oxide can significantly reduce pulmonary artery pressure, improve the expression of T lymphocytes and decrease the levels of C3 and C4 in children with congenital heart disease complicated with pulmonary hypertension.
【作者單位】： 右江民族醫(yī)學院附屬醫(yī)院胸心血管外科;
【基金】：國家自然科學基金資助項目(No.81560076)
【分類號】：R725.4

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