目的 探讨西地那非治疗新生儿持续肺动脉高压的疗效与安全性.方法 2005年1月至2008年10月收治持续肺动脉高压患儿45例,其中男25例,女20例;平均胎龄(39.3±2.4)周;平均出生体重(3 114.0±10.2)g;人院时平均年龄(13.0±0.8)h.病例随机分为西地那非、妥拉苏林和米力农治疗3组.应用超声心动仪检测肺动脉压力.结果 45例患儿中治愈30例,好转6例,无效9例,总有效率80.0%;西地那非、妥拉苏林和米力农3组患儿的治疗有效率比较,差异无统计学意义;3组患儿治疗前后平均肺动脉压力下降,差异有统计学意义;3组组间比较差异无统计学意义.所有患儿在治疗过程中均未见不良反应.结论 西地那非对新生儿持续肺动脉高压具有良好治疗效应,可有效降低平均肺动脉压力,改善心功能.%Objective To investigate the effect and safety of sildenafil on persistent pulmonary hypertension of the newborn (PPHN). Also compared the effect of sildenafil with tolazoline and milrione. Methods Forty five neonates with PPHN were recruited from January 2005 through October 2008 in NICU, 25 males and 20 females. The median gestational age was (39.3 + 2.4) weeks, the median birthweight was (3 114.0±10.2) g, and the median age were (13.0±0.8) hours. The patients were randomly assigned to receive sildenafil, tolazoline and milrione therapy. The pulmonary artery pressure (PAP) was measured by echocardiography. Results Thirty patients were cured, 6 patients were improved and 9 patients were of no effect. The total effective rate was 80%. There was no statistical difference among sildenafil, tolazoline and milrione. The PAP decreased when the patients were treated with sildenafil, tolazoline and milrione. No side effects happened in all patients treated with the three drugs. Conclusions Sildenafil is an effective and safe drug to reduce PAP of PPHN and it also help to improve cardiac function.
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