血管扩散剂治疗儿童初级肺高血压的治疗方法
R J Barst1, G Maislin, A P Fishman
1Department of Pediatrics, Columbia University, College of Physicians and Surgeons, New York, NY, USA.
长期的血管扩张疗法显著改善了患有原发性肺高血压 (PPH) 的儿童的生存率. 通道阻塞剂对急性反应者有效,而前环素 (PGI2) 对不反应者和对其他治疗无反应者有益.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 肺高血压研究 肺高血压研究
- 血管药理学 血管药理学
背景情况:
- 介绍了13年的小儿初级肺高血压 (PPH) 血管扩张器治疗经验.
- 将两个治疗时期进行比较:口服通道阻断剂 (1982-1987) 和静脉注射前环素 (PGI2) 在1987年后.
研究的目的:
- 评估PPH儿童血管扩张疗法的长期疗效.
- 根据患者的反应来确定不同血管扩张器策略的生存益处.
主要方法:
- 对74名儿童进行了静脉注射PGI2的短期血管扩张试验.
- 将患者分类为急性反应或不响应PGI的患者2.
- 用口服通道阻断剂治疗的响应者和长期使用PGI2或常规治疗的不响应者.
主要成果:
- 通道阻塞剂改善了31个响应者与43个不响应者 (P=0.0002) 相比的生存率.
- 与没有PGI2接入的人相比,长期PGI2治疗显著改善了非响应者的生存率 (P=0.0005).
- 总的来说,31名未能接受常规治疗的儿童在接受血管扩展剂治疗后的生存率有所改善 (P=0.002).
结论:
- 长期的血管扩张剂治疗对于改善儿科PPH的存活率至关重要.
- 口服通道阻塞剂通常足以治疗急性反应患者.
- 连续静脉注射PGI2输液可提高非反应者和耐卡管阻塞剂耐火者生存率.
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