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目的:探讨静脉滴注灯盏花素注射液治疗肺动脉高压合并右心功能不全患者的疗效。方法:入选美国纽约心脏病学会(NYHA)心功能Ⅲ级~Ⅳ级的新近诊断且未经治疗的动脉性肺动脉高压(PAH)合并右心功能不全的患者46例,随机分为灯盏花素组23例和对照组23例。灯盏花素组在常规治疗基础上加用灯盏花素注射液20mg静脉滴注,每日1次,连续使用14天。结果:灯盏花素组患者治疗前后收缩压[(98.09±8.91)mm Hg、(103.48±11.74)mm Hg,P=0.04]、6分钟步行距离[(242.26±62.24)m、(294.70±65.89)m,P=0.00]明显增加,NT-pro BNP明显下降[(6 032.52±3 917.82)pg/m L、(3 631.43±2 236.33)pg/m L,P=0.03],心功能明显改善,对照组仅NT-pro BNP明显下降[(6 032.52±3 917.82)pg/m L、(4 399.35±3 034.67)pg/m L,P=0.02],两组间治疗后6分钟步行距离差异有统计学意义[(294.70±65.89)m、(256.26±61.89)m,P=0.04]。结论:在常规治疗的基础上联合使用灯盏花素,可使肺动脉高压合并右心功能不全的患者运动耐量明显提高,且安全性良好,灯盏花素注射液有望成为治疗肺动脉高压合并右心功能不全患者的一种很有前景的药物。
Objective: To investigate the efficacy of intravenous infusion of Breviscapine injection in patients with pulmonary hypertension and right ventricular dysfunction. Methods: Forty-six patients with newly diagnosed and untreated pulmonary arterial hypertension (PAH) complicated with right ventricular dysfunction in the New York Heart Association (NYHA) class Ⅲ-Ⅳ were randomly divided into breviscapine group 23 cases and 23 cases of control group. Breviscapine group on the basis of conventional treatment plus breviscapine injection 20mg intravenous infusion, once daily for 14 days. Results: Before and after treatment, the systolic blood pressure in the breviscapine group was (98.09 ± 8.91) mm Hg, (103.48 ± 11.74) mm Hg, P = 0.04], and the distance of 6 minutes was 242.26 ± 62.24 m and 294.70 ± 65.89 respectively (P <0.05). Compared with the control group, NT-proBNP decreased significantly (P <0.05, P = 0.006) The NT-pro BNP level in the control group was significantly lower than that in the control group [(6 032.52 ± 3 917.82) pg / m L, (4 399.35 ± 3 034.67) pg / m L, P 0.02] Statistical significance [(294.70 ± 65.89) m, (256.26 ± 61.89) m, P = 0.04]. Conclusion: The combination of Breviscapine on the basis of conventional treatment can make patients with pulmonary hypertension and right ventricular dysfunction significantly increased exercise tolerance, and good safety Breviscapine injection is expected to be the treatment of pulmonary hypertension combined with right ventricular dysfunction A promising drug for patients.