Li Xinmei, Li Te
Yunnan Provincial Key Laboratory of Pharmacology, Kunming Medical University, Kunming, China.
Department of Pharmacy, Fuwai Yunnan Cardiovascular Hospital, Kunming, China.
Front Pharmacol. 2021 Apr 29;12:660405. doi: 10.3389/fphar.2021.660405. eCollection 2021.
Pulmonary arterial hypertension (PAH) associated with congenital heart disease (PAH-CHD) occurs predominantly among patients with uncorrected congenital heart disease (CHD). It is an intractable problem to control PAH continuously and stably after an operation. 1) OPLS-DA combined with S-plot was used to retrospectively analyze the results of preoperative and postoperative PAH and 39 biochemical indicators of 235 patients admitted to Fuwai Yunnan Cardiovascular Hospital from January 2019 to December 2020. 2) Combined with Meta-analysis, the recurrence in postoperative PAH was analyzed in terms of operation factors, doses administered, and age factors. 1) 4 indicators (PAH, RBC, HGB, and CO) that reflect the prognosis of patients had been found by OPLS-DA combined with S-plot. 2) The recurrence rate of postoperative PAH was 37.02%. The comprehensive therapeutic effect of interventional closure was better than that of surgical operation. PAH was not significantly higher again in patients who received either the instruction dose or the literature dose. Postoperative combination therapy (bosentan and sildenafil) was more effective than bosentan alone. Recovery after treatment was better in infants than in the other four age groups. OPLS-DA combined with S-plot was used for the first time to analyze clinical examination data. In this study, this method proved to be a feasible method for analyzing clinical data We recommend interventional closure as the first choice for patients with PAH-CHD. For postoperative oral therapy, we recommend the combination therapy (bosentan with sildenafil). To prevent the recurrence, the dose should be strictly prescribed according to the instructions, literature, or body surface area converted. Moreover, we recommend treatment at a young age in these patients.
先天性心脏病相关肺动脉高压(PAH-CHD)主要发生在未矫正先天性心脏病(CHD)患者中。术后持续稳定控制PAH是一个棘手的问题。1)采用正交偏最小二乘法判别分析(OPLS-DA)结合S图,对2019年1月至2020年12月在云南省阜外心血管病医院住院的235例患者术前和术后PAH及39项生化指标的结果进行回顾性分析。2)结合Meta分析,从手术因素、给药剂量和年龄因素等方面分析术后PAH的复发情况。1)通过OPLS-DA结合S图发现了4项反映患者预后的指标(PAH、RBC、HGB和CO)。2)术后PAH复发率为37.02%。介入封堵的综合治疗效果优于外科手术。接受指导剂量或文献剂量的患者PAH再次升高不明显。术后联合治疗(波生坦和西地那非)比单独使用波生坦更有效。婴儿治疗后的恢复情况优于其他四个年龄组。首次采用OPLS-DA结合S图分析临床检查数据。在本研究中,该方法被证明是一种分析临床数据的可行方法。我们建议将介入封堵作为PAH-CHD患者的首选治疗方法。对于术后口服治疗,我们建议采用联合治疗(波生坦与西地那非)。为防止复发,应严格按照说明书、文献或换算后的体表面积规定剂量。此外,我们建议对这些患者进行早期治疗。