卡托普利对左向右分流先天性心脏病肺动脉高压患者的血液动力学影响观察(1)

http://www.100md.com 2020年5月5日 《中国现代医生》 202013

     [摘要] 目的 觀察卡托普利对左向右分流先天性心脏病肺动脉高压患者的血液动力学影响。 方法 随机选取2018年5月～2019年5月我院左向右分流先天性心脏病患者30例，给予所有患者卡托普利治疗，治疗前、治疗后3～5 d分别采用彩色多普勒超声诊断仪(麦瑞Resona 75型)对患者的血液动力学指标进行检测，然后统计分析30例患者治疗前后的血液动力学。 结果 30例患者治疗后的PAMP、AMP、TSR均显著低于治疗前(P<0.05)。30例患者中治疗后19例TPR/TSR上升，11例TPR/TSR下降。TPR/TSR上升患者治疗后的AMP、TSR、Qp/Qs均显著低于治疗前(P<0.05)，TPR/TSR、Qs均显著高于治疗前(P<0.05);TPR/TSR下降患者治疗后的PAMP、AMP、PAMP/AMP、TPR、TPR/TSR均显著低于治疗前(P<0.05)，Qp/Qs显著高于治疗前(P<0.05)。治疗前TPR/TSR上升患者的TPR/TSR显著低于TPR/TSR下降患者(P<0.05)，但二者的PAMP、AMP、PAMP/AMP、TPR、TSR、Qp、Qs、Qp/Qs之间的差异均不显著(P>0.05)。 结论 卡托普利能够有效降低左向右分流先天性心脏病患者的肺动脉高压，但会提升患者的Qp/Qs。

    [关键词] 卡托普利;左向右分流先天性心脏病;肺动脉高压;血液动力学

    [中图分类号] R541.1 [文献标识码] B [文章编号] 1673-9701(2020)13-0039-04

    [Abstract] Objective To observe the hemodynamic effect of captopril on patients with pulmonary hypertension in congenital heart disease from left to right shunt. Methods 30 patients with congenital heart disease from left to right shunt in our hospital from May 2018 to May 2019 were randomly selected. All patients were treated with captopril. Color Doppler Ultrasound diagnostic equipment(Meri Resona 75) was used to test the patient's hemodynamic parameters before treatment and 3-5 days after treatment， and then the hemodynamics of 30 patients before and after treatment were statistically analyzed. Results PAMP， AMP and TSR in the 30 patients after treatment were significantly lower than those before treatment(P<0.05). Of the 30 patients， 19 had an increase in TPR/TSR and 11 had a decrease in TPR/TSR. The AMP， TSR and Qp/Qs of patients with elevated TPR/TSR were significantly lower than those before treatment(P<0.05)， and TPR/TSR and Qs were significantly higher than those before treatment(P<0.05). The PAMP， AMP， PAMP/AMP， TPR and TPR/TSR in patients with decreased TPR/TSR after treatment were significantly lower than those before treatment(P<0.05)， and Qp/Qs was significantly higher than that before treatment(P<0.05). The TPR/TSR of patients with elevated TPR/TSR before treatment was significantly lower than that of patients with decreased TPR/TSR(P<0.05)， but the difference in PAMP， AMP， PAMP/AMP， TPR， TSR， Qp， Qs， and Qp/Qs between two groups was not significant(P>0.05). Conclusion Captopril can effectively reduce pulmonary hypertension in patients with left-to-right shunt congenital heart disease， but it will increase the Qp/Qs of patients.

    [Key words] Captopril; Congenital heart disease from left to right shunt; Pulmonary hypertension; Hemodynamics, http://www.100md.com(林莉 叶士勇 施振华)

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