Treatment of primary pulmonary hypertension intravenous epoprostenol (prostacyclin).
Treatment of primary pulmonary hypertension intravenous epoprostenol (prostacyclin).
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治疗原发性肺动脉高压静脉注射依前列醇（前列环素）。
DOI：
10.1136/hrt.57.3.270
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发表时间：
1987
影响因子：
--
通讯作者：
J. Wallwork
中科院分区：
文献类型：
--
作者：
D. K. Jones;T. Higenbottam;J. Wallwork
对10例对口服血管扩张剂无反应的严重原发性肺动脉高压和明显残疾患者进行静脉注射丙烯醇（前列环素）治疗。所有患者均行心肺移植手术。短期给药（平均剂量5.5 ng/kg/min）使平均心脏指数从1.8增加到2.2 1/min/m2，肺动脉氧饱和度从48%提高到57%，计算组织氧输送从10增加到11.8 ml/kg/min。平均肺血管阻力下降18%，平均全身动脉压下降32%。只有两名患者肺动脉压升高。持续静脉输注epoprostenol 1-25个月与主观和临床改善相关。在渐进式运动测试中，通过最大耗氧量的增加来测量运动耐受性的提高。在治疗前能够运动的6名患者中，它从平均7毫升/公斤/分钟上升到15毫升/公斤/分钟。那些在治疗前无法运动的人在治疗后的耗氧量达到了相当的水平。两名患者在治疗过程中死亡，三名患者接受了心肺移植，五名患者的治疗仍在继续。并发症包括败血症和腹水的发作。在这项对严重肺动脉高压患者的非对照研究中，丙烯醇似乎为血管扩张剂患者提供了一种最佳剂量的方法，以降低肺血管阻力，从而增加心输出量和氧组织输送。没有证据表明这种治疗影响了疾病的进展。
Ten patients with severe primary pulmonary hypertension and pronounced disability who were unresponsive to oral vasodilators were treated with intravenous epoprostenol (prostacyclin). All had been referred for heart and lung transplantation. Short term administration of epoprostenol (mean dose 5.5 ng/kg/min) increased the mean cardiac index from 1.8 to 2.2 1/min/m2, improved pulmonary artery oxygen saturation from 48% to 57%, and increased calculated tissue oxygen delivery from 10 to 11.8 ml/kg/min. The mean pulmonary vascular resistance fell by 18% while mean systemic artery pressure fell by 32%. Pulmonary artery pressure rose in only two patients. Continued intravenous infusion of epoprostenol for 1-25 months was associated with subjective and clinical improvement. Exercise tolerance improved as measured by an increase in the maximum rate of oxygen consumption during progressive exercise testing. In those six patients who were able to exercise before treatment it rose from a mean of 7 to 15 ml/kg/min. Those who had been unable to exercise before treatment achieved comparable rates of oxygen consumption after treatment. Two patients died on treatment, three have undergone heart-lung transplantation, and in five the treatment is continuing. Complications included episodes of septicaemia and ascites. In this uncontrolled study of patients with severe pulmonary hypertension epoprostenol seemed to offer a means of optimally dosing the patients with a vasodilator to reduce pulmonary vascular resistance and thus increasing cardiac output and oxygen tissue delivery. There was no evidence to suggest that this treatment influenced the progress of the disease.
硝苯地平治疗原发性肺动脉高压。
影响因子：
39.2
作者：
Rubin,LJ;Nicod,P;Hillis,LD;Firth,BG
通讯作者：
Firth,BG