Hoeper M M, Schwarze M, Ehlerding S, Adler-Schuermeyer A, Spiekerkoetter E, Niedermeyer J, Hamm M, Fabel H
Abteilung Pneumologie, Medizinische Hochschule Hannover.
Pneumologie. 2001 Jan;55(1):38-43. doi: 10.1055/s-2001-10443.
Continuous intravenous infusion of prostacyclin is an effective treatment for primary pulmonary hypertension. This approach, however, requires the insertion of a permanent central venous catheter with the potential risk of serious complications. Recently, administration of aerosolized iloprost, a stable prostacyclin analogue, has been introduced as an alternative therapy for severe pulmonary hypertension.
We evaluated the effects of treatment with aerosolized iloprost over a one-year period on exercise capacity and hemodynamic variables in patients with primary pulmonary hypertension.
Twenty-four patients with primary pulmonary hypertension received aerosolized iloprost at a cumulative daily dose of 100 to 150 micrograms for at least one year. The mean (+/- SD) walking distance in the 6-min-walk test increased from 278 +/- 96 meters at base line to 363 +/- 135 meters after 12 months (P < 0.0001). During the same period, the mean pulmonary artery pressure declined from 59 +/- 10 mmHg to 52 +/- 15 mmHg (P = 0.006), the cardiac output increased from 3.8 +/- 1.4 l/min to 4.4 +/- 1.3 l/min (P = 0.02), and the pulmonary vascular resistance declined from 1.205 +/- 467 dynes.s.cm-5 to 925 +/- 469 dynes.s.cm-5 (P = 0.0003). Treatment was generally well tolerated and except for mild coughing, minor headache and jaw pain in some patients, no side effects occurred.
Long-term treatment with aerosolized iloprost is safe and has sustained effects on exercise capacity and pulmonary hemodynamics in patients with primary pulmonary hypertension.
持续静脉输注前列环素是治疗原发性肺动脉高压的有效方法。然而，这种方法需要插入永久性中心静脉导管，存在严重并发症的潜在风险。最近，雾化吸入伊洛前列素（一种稳定的前列环素类似物）已被引入作为重度肺动脉高压的替代治疗方法。
我们评估了雾化吸入伊洛前列素治疗一年对原发性肺动脉高压患者运动能力和血流动力学变量的影响。
24例原发性肺动脉高压患者接受雾化吸入伊洛前列素治疗，累积日剂量为100至150微克，至少治疗一年。6分钟步行试验中的平均（±标准差）步行距离从基线时的278±96米增加到12个月后的363±135米（P<0.0001）。在同一时期，平均肺动脉压从59±10mmHg降至52±15mmHg（P = 0.006），心输出量从3.8±1.4升/分钟增加到4.4±1.3升/分钟（P = 0.02），肺血管阻力从1.205±467达因·秒·厘米⁻⁵降至925±469达因·秒·厘米⁻⁵（P = 0.0003）。治疗一般耐受性良好，除了一些患者出现轻度咳嗽、轻微头痛和颌部疼痛外，未发生副作用。
雾化吸入伊洛前列素长期治疗对原发性肺动脉高压患者的运动能力和肺血流动力学具有持续影响，且安全性良好。
