雾化吸入伊洛前列素对肺动脉高压患者血液动力学的影响

摘要

目的 探讨雾化吸入进口伊洛前列素对肺动脉高压患者血液动力学的影响.方法 选择各类型肺动脉高压患者共17例,应用Swan-Ganz漂浮导管和有创动脉监测进行血液动力学监测,对比吸入伊洛前列素前后的体、肺循环血液动力学参数和氧合指数,并观察不良反应.结果 吸入伊洛前列素后各项血液动力学和氧合参数对比:心率[(87±12)次/分VS(85±14)次/分,P = 0.13 ];平均右房压[(10±5)mmHg VS(9±5) mmHg,P = 0.23];平均肺动脉压力[(78±23)mmHg VS(67±19)mmHg,P = 0.03];肺循环阻力[(15.8±5.3)woods VS(11.6±4.7)woods,P = 0.02];心排量[(4.3±1.1)L/min VS(4.9±1.4) L/min,P = 0.04];平均肺血管楔压[(10±4)mmHg VS(10±3)mmHg,P = 0.35];混合静脉血氧饱和度[(65±3)%VS(67±3)%,P = 0.14];平均体动脉压[(84±12) mmHg VS(83±11)mmHg,P = 0.08];体循环阻力[(17.2±5.1)woods VS(15.1±4.0)woods,P = 0.08];动脉血氧饱和度[(92±4)%VS(93±3)%,P = 0.44];不良反应轻微,呛咳、颜面潮红各2例,头痛1例.结论 雾化吸入伊洛前列素可以显著改善肺动脉高压患者肺循环参数,不良反应轻微.%Objective To study the acute hemodynamic effects of Iloprost Solution for Inhalation on patients with pulmonary hypertension.Methods Seventeen patients with pulmonary hypertension underwent hemodynamic monitoring by Swan-Ganz floating catheter and invasive arterial monitoring.Hemodynamic parameters of pulmonary and blood circulation, oxygenation index and adverse reactions before and after use of Iloprost Solution for Inhalation were observed and compared.Results Hemodynamic and oxygenation parameters before and after use of Iloprost Solution for Inhalation were as follows:heart rate [(87 ± 12) beats/min VS (85 ± 14)beats/min,P = 0.13], mean right atrial pressure [( 10 ± 5 ) mmHg VS ( 9 ± 5 ) mmHg, P = 0.23], mean pulmonary arterial pressure [(78 ±23) mmHg VS (67 ± 19) mmHg,P =0.03],pulmonary vascular resistance [( 15.8 ±5.3) woods VS ( 11.6 ±4.7) woods,P=0.02],cardiac output [(4.3 ± 1.1 ) L/min VS (4.9 ± 1.4) L/min,P =0.04],mean pulmonary capillary wedge pressure [( 10 ±4 ) mmHg VS ( 10 ± 3 ) mmHg,P = 0.35], mixed venous oxygen saturation [( 65 ± 3 ) ％ VS ( 67 ± 3)％, P = 0.14], mean systemic arterial pressure [( 84 ± 12) mmHg VS ( 83 ± 11 ) mmHg, P = 0.08], systemic vascular resistance [( 17.2 ± 5.1 ) woods VS ( 15.1 ±4.0 ) woods, P = 0.08], arterial oxygen saturation [( 92 ± 4 ) ％ VS ( 93 ± 3 ) ％, P = 0.44].Adverse reactions were mild, included 2 cases of cough and blushing respectively, and 1 case of headache.Conclusion Iloprost Solution for Inhalation can significantly improve pulmonary circulation hemodynamic parameters in patients with pulmonary hypertension with mild adverse reactions.