西地那非对新生儿肺动脉高压患儿 血浆细胞因子的影响及疗效研究

Effect of Silaenafil on plasma cytokines in neonates with pulmonary hypertension and its therapeutic effect

摘要:

目的 研究西地那非对新生儿肺动脉高压患儿血浆细胞因子的影响及疗效。方法 选取2010 年5 月- 2017 年5 月西南医科大学附属医院新生儿科住院治疗的肺动脉高压患儿136 例作为研究对象，随机分为观察 组与对照组。两组研究对象确诊后均给予常规治疗，观察组在常规治疗基础上加用西地那非治疗。检测三尖 瓣反流速度，计算肺动脉压；检测并记录血氧饱和度（SpO2）、动脉血氧分压（PaO2）、动脉血二氧化碳分压 （PaCO2）及动脉血pH 值；酶联免疫吸附法检测脑钠肽（BNP）、内皮素1（ET-1）、肿瘤坏死因子α（TNF-α）、 血管紧张素1（ANG-1）及白细胞介素8（IL-8）。结果 两组研究对象治疗前PAP、SpO2、PaO2、PaCO2 及 PH 值比较差异无统计学意义（P >0.05）；治疗后两组研究对象PAP、SpO2、PaO2、PaCO2 及pH 值比较差异 有统计学意义（P <0.05），观察组SpO2、PaO2 及pH 值高于对照组，PAP 和PaCO2 低于对照组。两组研究对 象治疗前BNP、ET-1、TNF-α、ANG-1 及IL-8 比较差异无统计学意义（P >0.05）；治疗后两组研究对 象BNP、ET-1、TNF-α、ANG-1 及IL-8 比较差异有统计学意义（P <0.05），观察组ANG-1 高于对照组， BNP、ET-1、TNF-α 及IL-8 低于对照组。结论 西地那非对新生儿肺动脉高压有良好的治疗效果，且对血 浆细胞因子有一定影响。

Abstract:

Objective To study the effect of Silaenafil on plasma cytokines in neonates with pulmonary hypertension and the therapeutic effect . Methods Totally 136 cases diagnosed with neonatal pulmonary hypertension in our hospital between May 2010 and May 2017 were received. They were randomly divided into an observation group and a contrast group. The two groups were given regular therapy after diagnosis, the observation group received Silaenafil treatment on conventional treatment. The velocity of tricuspid regurgitation was measured by GE doppler echocardiogram, and pulmonary artery pressure (PAP) was calculated with simplified Bernoulli equation. Blood oxygen saturation (SpO2), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) and pH value (pH) of arterial blood were detected and recorded by ABL520 automatic blood gas system. BNP, ET-1, TNF-α, ANG-1 and IL-8 were assayed by enzyme linked immunosorbent assay. Results There was no significant difference in PAP, SpO2, PaO2, PaCO2 or pH between the two groups before treatment (P >0.05). After therapy, SpO2, PaO2 and pH in the observation group were higher than those of the control group, PAP and PaCO2 were lower than those of the control group. The differences were not statistically significant in the levels of BNP, ET-1, TNF-α, ANG-1 and IL-8 between the two groups before treatment (P > 0.05). After therapy, there were significant differences in the levels of BNP, ET-1, TNF-α, ANG-1 and IL-8 between the two groups (P < 0.05); the level of ANG-1 in the observation group was higher than the control group; BNP, ET-1, TNF-α and IL-8 levels were lower than those of the control group. Conclusions Silaenafil therapy has good therapeutic effect on neonatal pulmonary hypertension in neonates and may affect plasma cytokines.