Nenci G G, Berrettini M, Todisco T, Costantini V, Parise P
Istituto di Semeiotica Medica, University of Perugia, Italy.
Respiration. 1988;53(1):13-9. doi: 10.1159/000195390.
Based on the hypothesis that blood platelets contribute to the pathogenesis of hypoxemic pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD), the effect of a prolonged treatment with dipyridamole, a platelet-inhibiting drug, on hypoxemic pulmonary hypertension was evaluated in a double-blind cross-over study. Eight patients with COPD, pulmonary hypertension [mean systolic pressure 52.2 +/- (SD) 9.7 mm Hg; mean diastolic pressure 25.8 +/- (SD) 6.8 mm Hg] and shortened platelet regeneration time [mean 5.2 +/- (SD) 1.2 days] received, in a cross-over random sequence, the following two 3-month treatments: (a) dipyridamole 100 mg and acetylcysteine 100 mg every 6 h; (b) acetylcysteine, 100 mg every 6 h. Dipyridamole significantly prolonged the platelet regeneration time [mean 6.5 +/- (SD) 1.0 days; p less than 0.05]. There was no significant effect on diastolic pulmonary pressure. However, systolic pressure was significantly (p less than 0.05) lower after dipyridamole [46.8 +/- (SD) 16 mm Hg] than after placebo [56.1 +/- (SD) 14 mm Hg]. These results suggest that dipyridamole can slow the progression of hypoxemic pulmonary hypertension in patients with COPD.
基于血小板在慢性阻塞性肺疾病（COPD）患者低氧性肺动脉高压发病机制中起作用的假设，在一项双盲交叉研究中评估了血小板抑制药物双嘧达莫长期治疗对低氧性肺动脉高压的影响。8例COPD患者，伴有肺动脉高压[平均收缩压52.2±（标准差）9.7mmHg；平均舒张压25.8±（标准差）6.8mmHg]以及血小板再生时间缩短[平均5.2±（标准差）1.2天]，按照交叉随机顺序接受以下两种为期3个月的治疗：（a）双嘧达莫100mg和乙酰半胱氨酸100mg，每6小时一次；（b）乙酰半胱氨酸，每6小时100mg。双嘧达莫显著延长了血小板再生时间[平均6.5±（标准差）1.0天；p<0.05]。对舒张期肺动脉压无显著影响。然而，双嘧达莫治疗后收缩压[46.8±（标准差）16mmHg]显著低于安慰剂组[56.1±（标准差）14mmHg]（p<0.05）。这些结果表明双嘧达莫可减缓COPD患者低氧性肺动脉高压的进展。
