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目的:探讨吸入型伊洛前列素和西地那非2种药物联合应用及单独用药在治疗重度肺动脉高压患者中的效价。方法:29例肺动脉高压患者随机分为单独应用伊洛前列素组(I组)、西地那非组(S组)和伊洛前列素续减合并西地那非递增的联合治疗组(I+S组),观察治疗4、12、24周时3组的临床疗效和经费。结果:治疗12周时,I组及I+S组较S组在心排出量、6min步行距离和心功能WHO分级的改善方面均有明显差异(P<0.05);但I组与I+S组相比疗效无显著差异;治疗24周时,3组疗效均无显著差异(P>0.05)。12周及24周时I+S组治疗费用较I组明显减少,分别节省32%及64%,S组治疗费用最低。结论:吸入伊洛前列素合并口服西地那非的续减递增联合治疗是重度肺动脉高压患者高效价的治疗方案。
OBJECTIVE: To investigate the efficacy and safety of two combinations of inhaled iloprost and sildenafil in the treatment of patients with severe pulmonary hypertension. Methods: Twenty-nine patients with pulmonary hypertension were randomly divided into two groups: the ioprost group (group I), the sildenafil group (group S), and the iloprost regressive combined with sildenafil (I + S group). The clinical curative effect and funding of 3 groups were observed at 4, 12 and 24 weeks after treatment. Results: At 12 weeks of treatment, there was a significant difference (P <0.05) between I group and I + S group in terms of cardiac output, 6-minute walking distance and improvement of WHO functional classification (P <0.05) There was no significant difference between the three groups (P> 0.05). At 12 weeks and 24 weeks, I + S treatment costs were significantly reduced compared with I group, saving 32% and 64%, respectively, S group the lowest cost of treatment. CONCLUSIONS: The combination therapy of inhalation of iloprost combined with continuous reduction of oral sildenafil is a high titer treatment for patients with severe pulmonary hypertension.