Shen Jieyan, He Ben, Wang Binyao
Department of Cardiology, Shanghai Second Medical University--Affiliated Renji Hospital, 1630 Dong Fang Rd, Shanghai 200127, Republic of China.
Chest. 2005 Aug;128(2):714-9. doi: 10.1378/chest.128.2.714.
To determine whether lipid microspheres containing prostaglandin E1 (lipo-PGE1) improve pulmonary hemodynamics and clinical outcomes in patients with pulmonary arterial hypertension (PAH).
Forty-nine patients with PAH (8 patients with primary pulmonary hypertension, 21 patients with collagen vascular disease, 20 patients with congenital systemic-to-pulmonary shunts) were randomly classified into a conventional therapy group (n = 22) or a group receiving lipo-PGE1 plus conventional drugs (lipo-PGE1 group; n = 27). Echocardiographic pulmonary parameters, New York Heart Association (NYHA) functional class, and Bruce treadmill test results for exercise capacity were recorded before and after treatment.
After 2 weeks of treatment with lipo-PGE1 (10 microg bid for 14 days), there were significant improvements in the values (+/- SD) for systolic pulmonary arterial pressure (SPAP) [76.9 +/- 27.9 mm Hg vs 66.5 +/- 22.8 mm Hg, p < 0.001]; total pulmonary resistance (27.2 +/- 13.3 dyne.s.cm(-5) vs 20.2 +/- 10.7 dyne.s.cm(-5), p < 0.001); left ventricular ejection fraction (58.7 +/- 9.6% vs 64.4 +/- 6.8%, p < 0.001); and cardiac output (3.1 +/- 0.8 L/min vs 3.7 +/- 1.1 L/min, p < 0.01). The NYHA functional class decreased from 3.0 +/- 0.6 to 2.5 +/- 0.6 (p < 0.001), and the exercise capacity increased from 2.8 +/- 1.0 to 4.3 +/- 1.3 metabolic equivalents (MET) [p < 0.001]. Compared with the conventional therapy group, the lipo-PGE(1) group achieved significant reduction of SPAP (10.4 +/- 10.3 mm Hg vs 2.2 +/- 5.6 mm Hg, p = 0.002) and a significant elevation of exercise capacity (1.5 +/- 0.9 MET vs 0.6 +/- 1.1 MET, p = 0.018).
Lipo-PGE1 can decrease pulmonary artery pressure and increase exercise capacity in patients with PAH.
确定含前列腺素E1的脂质微球（脂微球前列地尔）是否能改善肺动脉高压（PAH）患者的肺血流动力学和临床结局。
49例PAH患者（8例原发性肺动脉高压患者、21例胶原血管病患者、20例先天性体-肺分流患者）被随机分为传统治疗组（n = 22）或接受脂微球前列地尔加传统药物治疗的组（脂微球前列地尔组；n = 27）。记录治疗前后的超声心动图肺参数、纽约心脏协会（NYHA）功能分级以及布鲁斯平板运动试验的运动能力结果。
接受脂微球前列地尔治疗2周（10μg，每日2次，共14天）后，收缩期肺动脉压（SPAP）值（±标准差）有显著改善[76.9±27.9mmHg对66.5±22.8mmHg，p < 0.001]；总肺阻力（27.2±13.3达因·秒·厘米⁻⁵对20.2±10.7达因·秒·厘米⁻⁵，p < 0.001）；左心室射血分数（58.7±9.6%对64.4±6.8%，p < 0.001）；以及心输出量（3.1±0.8L/分钟对3.7±1.1L/分钟，p < 0.01）。NYHA功能分级从3.0±0.6降至2.5±0.6（p < 0.001），运动能力从2.8±1.0代谢当量（MET）增加至4.3±1.3MET [p < 0.001]。与传统治疗组相比，脂微球前列地尔组的SPAP显著降低（10.4±10.3mmHg对2.2±5.6mmHg，p = 0.002），运动能力显著提高（1.5±0.9MET对0.6±1.1MET p = 0.018）。
脂微球前列地尔可降低PAH患者的肺动脉压并提高运动能力。
