Effect of Sildenafil Citrate on Pulmonary Arterial Systolic Pressure and Sub-maximal Exercise Capacity in Chronic Obstructive Pulmonary Disease.
Effect of Sildenafil Citrate on Pulmonary Arterial Systolic Pressure and Sub-maximal Exercise Capacity in Chronic Obstructive Pulmonary Disease.
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发表时间：
2017
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通讯作者：
S. Shrestha;B. Srivastava;M. Karki;D. Khatri;R. Pradhan
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作者：
S. Shrestha;B. Srivastava;M. Karki;D. Khatri;R. Pradhan
背景 肺动脉高压 (PH) 常常使慢性阻塞性肺疾病 (COPD) 复杂化。西地那非可降低与多种疾病相关的肺动脉压。目的评价西地那非在慢性阻塞性肺病合并肺动脉高压中的应用。方法 这项随机对照研究招募了 72 名患者：其中 61 名完成了研究。 30 名慢性阻塞性肺病患者接受西地那非 25 毫克，每日三次，31 名慢性阻塞性肺病患者接受了为期 4 周的最佳药物治疗。症状评估和呼吸困难分级采用改良博格量表和改良医学研究委员会 (MMRC) 分级。功能评估是根据 WHO 功能分类进行的。在两组治疗前和治疗后 4 周进行肺动脉收缩压和六分钟步行距离的估计。对西地那非进行了不良反应分析。主要结果是肺动脉收缩压和六分钟步行测试的变化。次要结果是改良 Borg 呼吸困难量表、MMRC 分级和 WHO 功能分级的变化。结果 西地那非组肺动脉收缩压平均下降较对照组显着（9.87+7.84 mmHg vs 5.93+7.44 mmHg，P=0.048）。与对照组相比，病例组六分钟步行距离的平均增加明显更多（48.13+25.79 m Vs 32.59+32.96 m，P=0.047）。改良Borg量表变化不显着（1.20+1.92至1.55+1.23；P=0.401）。 MMRC 等级有显着变化 (p=0.037)。四周后 WHO 功能分级没有显着变化 (p=0.071)。结论 西地那非略微降低了 COPD 患者的肺动脉收缩压并增加了六分钟步行距离。它改进了 MMRC 分级，而不影响修改后的 Borg 量表和 WHO 功能分级。
Background Pulmonary hypertension (PH) often complicates Chronic Obstructive Pulmonary Disease (COPD). Sildenafil reduces pulmonary arterial pressure associated with multitude of diseases. Objective To evaluate the use of Sildenafil in Pulmonary Hypertension associated with COPD. Method This randomized control study enrolled 72 patients: 61 completed the study. Thirtypatients with COPD received Sildenafil 25 mg thrice daily and 31 patients with COPD received optimal medical therapy for four weeks. Symptom assessment and dyspnoea grading was done with modified Borg scale and Modified Medical Research Council (MMRC) grade. The functional assessment was done with WHO functional classification. The estimation of pulmonary arterial systolic pressure and six minute walking distance was done before and after four weeks of the administration of therapy in both groups. Adverse reaction profiling was done for Sildenafil. The primary outcomes were the changes in pulmonary arterial systolic pressure and six minute walk test. The secondary outcomes were change in modified Borg scale for dyspnoea, MMRC grading and WHO functional class. Result The mean decrease in pulmonary arterial systolic pressure in Sildenafil group was significant as compared to controls (9.87+7.84 mmHg Vs 5.93+7.44 mmHg, P=0.048). The mean increase in six minute walk distance was significantly more in cases as compared to controls (48.13+25.79 m Vs 32.59+32.96 m,P=0.047). The changes in modified Borg scale was not significant (1.20+1.92 to 1.55+1.23; P=0.401). There was significant changes in MMRC grade (p=0.037). There was no significant change in WHO functional class after four weeks (p=0.071). Conclusion Sildenafil marginally decreased pulmonary arterial systolic pressure and increased six minute walk distance in COPD patients. It improved MMRC grading without affecting modified Borg's Scale and WHO functional class.