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[前列环素12类似物(依前列醇和曲前列尼尔)治疗婴儿难治性支气管肺发育不良所致肺动脉高压]

[Prostaglandin 12 analogs (epoprostenol and treprostinil) as a treatment for refractory bronchopulmonary dysplasia-induced pulmonary hypertension in an infant].

作者信息

Puente Ubierna Nuria, Bachiller Carnicero Luis, Corredera Sánchez Araceli, Martínez Orgado José A, Del Cerro Marín María J

机构信息

Servicio de Pediatría y Neonatología, Hospital Clínico San Carlos, Madrid, España.

Servicio de Pediatría, Hospital Ramón y Cajal, Madrid, España.

出版信息

Arch Argent Pediatr. 2019 Aug 1;117(4):e413-e415. doi: 10.5546/aap.2019.e413.

Abstract

Pulmonary hypertension is a common complication of bronchopulmonary dysplasia, with a high mortality rate. Despite the high incidence of pulmonary hypertension, there are few available treatments. Epoprostenol and treprostinil are prostaglandin I2 analogs that activate adenylate cyclase and increase cyclic adenosine monophosphate in the pulmonary arterial smooth muscle cells. Therefore, they may be an effective treatment for these patients. We report the use of prostaglandin I2 analogs in an extremely low birth weight preterm baby with severe bronchopulmonary dysplasia associated with pulmonary hypertension non-responding to inhaled nitric oxide and sildenafil. In our patient this treatment resulted in remarkable clinical and echocardiographic improvement, evident after a few weeks of treatment.

摘要

肺动脉高压是支气管肺发育不良的常见并发症,死亡率很高。尽管肺动脉高压发病率高,但可用的治疗方法却很少。依前列醇和曲前列尼尔是前列腺素I2类似物,可激活腺苷酸环化酶并增加肺动脉平滑肌细胞中的环磷酸腺苷。因此,它们可能是这些患者的有效治疗方法。我们报告了在一名极低出生体重的早产婴儿中使用前列腺素I2类似物的情况,该婴儿患有严重的支气管肺发育不良并伴有肺动脉高压,对吸入一氧化氮和西地那非无反应。在我们的患者中,这种治疗导致了显著的临床和超声心动图改善,在治疗几周后就很明显。

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