上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (9): 1287-.doi: 10.3969/j.issn.1674-8115.2011.09.017

• 论 著 • 上一篇    下一篇

伐地那非治疗先天性心脏病术后肺动脉高压的疗效观察

龚霄雷, 朱丽敏, 蔡小满, 徐卓明   

  1. 上海交通大学 医学院附属上海儿童医学中心心胸外科, 上海 200127
  • 出版日期:2011-09-28 发布日期:2011-09-27
  • 通讯作者: 徐卓明, 电子信箱: zmxyfb@yahoo.com.cn。
  • 作者简介:龚霄雷（1985—）, 男, 硕士生；电子信箱: espresso_1985@126.com。

Therapeutic effect of vardenafil on pulmonary hypertension after operation for congenital heart disease

GONG Xiao-lei, ZHU Li-min, CAI Xiao-man, XU Zhuo-ming   

  1. Department of Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2011-09-28 Published:2011-09-27

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摘要：

目的 评估磷酸二酯酶5抑制剂伐地那非用于先天性心脏病术后合并肺动脉高压治疗的临床效果。方法 对12例先天性心脏病行双心室修补术后发生肺动脉高压的患儿给予口服伐地那非治疗；用药后定期随访，观察药物的临床疗效和不良反应。结果 患儿口服伐地那非前的肺动脉压为（71±19）mmHg（1 mmHg=0.133 kPa）；服用后3个月和6个月的肺动脉压分别为（48±23）mmHg和（34±13）mmHg，与用药前比较，差异均有统计学意义（P<0.05）。用药后，患儿的心功能分级（NYHAFC）明显改善(P<0.01)。10例患儿在服药后3个月进行的6 min步行试验中，步行距离为（413±58）m，较用药前的(382±68)m明显增加(P<0.01)。服用伐地那非的主要不良反应为面部潮红，发生率为33.33%（4/12）。1例患儿由于服药后3个月心电图提示QT间期延长而停止用药。结论 伐地那非可降低双心室修补术后患儿的肺动脉压，增加患儿的活动耐量，改善NYHAFC。患儿用药后无严重不良反应，服药期间需监测心电图QT间期的变化。

关键词: 先天性心脏病, 肺动脉高压, 伐地那非, 疗效

Abstract:

Objective To assess the application of phosphodiesterase 5 inhibitor vardenafil to pulmonary hypertension after operation for congenital heart disease. Methods Twelve children with pulmonary hypertension after bi-ventricular repair for congenital heart disease were treated with vardenafil. Routine follow up was conducted after medication, and therapeutic effect and adverse effects were observed. Results The pulmonary hypertension was (71±19) mmHg (1 mmHg=0.133 kPa) before treatment with vardenafil, those were (48±23) mmHg and (34±13) mmHg 3 months and 6 months after treatment with vardenafil respectively, and there were significant differences between that before treatment with vardenafil and those 3 months and 6 months after treatment with vardenafil （P<0.05）. The New York Heart Association Functional Class (NYHAFC) significantly improved after treatment with vardenafil (P<0.01). The 6 min walking distance (6MWD) of 10 patients 3 months after treatment with vardenafil was significantly longer than that before treatment with vardenafil [(413±58) m vs (382±68) m, P<0.01]. The major side effect of vardenafil was facial flushing, and the incidence was 33.33%(4/12). One patient with prolonged Q-T interval on electrocardiogram 3 months after treatment with vardenafil stopped medication. Conclusion Vardenafil can decrease pulmonary hypertension after bi-ventricular repair for congenital heart disease, increase exercise capacity, and improve NYHAFC of children. There is no severe side effects after treatment with vardenafil, while the changes of Q-T interval on electrocardiogram should be monitored during medication.

Key words: congenital heart disease, pulmonary hypertension, vardenafil, therapeutic effect