目的 观察西地那非治疗对肺动脉高压患者的临床疗效和安全性.方法 连续入选2009年5月～2011年10月在我院就诊的肺动脉高压患者56例,其中男11例,女45例,年龄(31±11)岁.给予西地那非25 mg口服,3次/d,记录治疗前和治疗12周后患者6min步行距离、Borg呼吸困难指数、血流动力学改变、血常规和血生化变化.结果 治疗12周后,6 min步行距离由(352±80)m增加至(396±78)m；差值为(44±70)m(P＜ 0.01)；肺动脉平均压降低(6±14)mm Hg、肺血管阻力降低(490±232)dyn/(s· cm5)(均P＜0.01).心输出；量增加(1.1±0.2)L/min(P＜ 0.01),心指数增加(0.7±0.1)L/(min· m2)(P＜0.01).且患者治疗后红细胞、血红蛋白、国际化标准比值、天冬氨酸转氨酶指标亦优于治疗前(P＜0.05).结论 西地那非治疗可显著改善肺动脉高压患者的临床疗效,值得临床推广.%Objective To investigate the efficacy and safety of Sildenafil in the treatment of patients with pulmonary hypertension. Methods 56 cases of patients with pulmonary hypertension in our hospital from May 2009 to October 2011 were selected as the object, of which, 11 cases were male, 45 cases were female, the average age was (31±11) years old. They were all given Sildenafil 25 mg, 3 times/d. 6 min walking distance, Borg dyspnea index, hemodynamic changes, blood routine and blood biochemistry were recorded. Results After treatment for 12 weeks, 6 min walking distance increased from (352±80) m to (396±78) m; the difference was (44±70) m (P < 0.01); mean pulmonary arterial pressure decreased (6±14) mm Hg, pulmonary vascular resistance decreased (490±232) dyn/(s·cm5) (P < 0.01). Cardiac output increased (1.1±0.2) L/min (P < 0.01); cardiac index increased (0.7±0.1) L/(min·m2) (P < 0.01), and the results of erythrocyte, hemoglobin, international standard ratio and AST after treatment were all better than before treatment (P < 0.05). Conclusion The treatment of Sildenafil can significantly improve the clinical effect of patients with pulmonary hypertension and is worthy of clinical application.
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