内科

目的分析丹红注射液联合前列地尔治疗慢性肺源性心脏病合并肺动脉高压（PH）患者的临床效果及对肺动脉压、心功能、血管顺应性的影响。方法选取2018年9月至2020年12月我科收治的慢性肺源性心脏病合并PH患者105例作为研究对象，采用随机数字法分为对照组（52例）和观察组（53例）。对照组患者给予丹红注射液治疗，观察组患者在对照组的基础上给予前列地尔治疗，疗程2周。比较两组患者的临床疗效；检测比较两组患者治疗前后的肺动脉压、心功能及血管顺应性。结果治疗2周，观察组患者的治疗总有效率（96.23%）显著高于对照组（76.92%），差异有统计学意义（P＜0.05）。治疗前，两组患者的肺动脉收缩压（PASP）、肺动脉舒张压（PADP）、平均肺动脉压（MPAP）比较，差异无统计学意义（P＞0.05）；治疗2周后，两组患者的PASP、PADP、MPAP均显著降低，观察组患者的水平显著低于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的左室射血分数（LVEF）、心排血量（CO）、耗氧量（VO2）比较，差异无统计学意义（P＞0.05）；治疗2周后，两组患者的LVEF、CO均显著升高，VO2均显著降低，观察组患者的LVEF、CO均显著高于对照组，VO2显著低于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的肺血管顺应性、肺血管总阻力（TPVR）比较，差异无统计学意义（P＞0.05）。治疗2周后，两组患者的肺血管顺应性均显著升高，观察组患者的水平显著高于对照组；两组患者的TPVR均显著降低，观察组患者的水平显著低于对照组，差异有统计学意义（P＜0.05）。结论丹红注射液联合前列地尔治疗可有效改善慢性肺源性心脏病合并肺动脉高压患者的临床疗效及血管顺应性，明显降低患者的肺动脉压，显著提高患者的心功能。

ObjectiveTo analyze the clinical effect of Danhong injection combined with alprostadil in the treatment of patients with chronic cor pulmonale complicated with pulmonary hypertension (PH) and its influence on pulmonary artery pressure, cardiac function and vascular compliance. MethodsA total of 105 patients with chronic cor pulmonale complicated with PH admitted to our department from September 2018 to December 2020 were selected as the research objects, and they were divided into control group (52 cases) and observation group (53 cases) according to the random number method. The control group was treated with Danhong injection, while the observation group was given alprostadil treatment based on the control group, for a 2-week treatment course. The clinical effects of the two groups were compared. Pulmonary artery pressure, cardiac function and vascular compliance were detected and compared between the two groups before and after treatment. ResultsWith 2 weeks of treatment, the total effective rate of treatment of the observation group (96.23%) was significantly higher than that of the control group (76.92%), with a statistically significant difference (P＜0.05). Before treatment, there were no statistically significant differences in pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), mean pulmonary artery pressure (MPAP) between the two groups (P＞0.05). After 2 weeks of treatment, PASP, PADP and MPAP significantly decreased in both groups, and the levels in the observation group was significantly lower than those in the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in left ventricular ejection fraction (LVEF), cardiac output (CO), oxygen consumption (VO2) between the two groups (P＞0.05). After 2 weeks of treatment, LVEF and CO increased significantly and VO2 decreased significantly in both groups, while the LVEF and CO in the observation group were significantly higher than those in the control group, and VO2 was lower than that in the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in pulmonary vascular compliance and total pulmonary vascular resistance (TPVR) between the two groups (P＞0.05). After 2 weeks of treatment, pulmonary vascular compliance in both groups increased significantly, with significantly higher levels in the observation group than in the control group. After 2 weeks of treatment, TPVR decreased significantly in both groups, which was lower in the observation group than that of the control group, with a statistically significant difference (P＜0.05). ConclusionDanhong injection combined with alprostadil can effectively improve the clinical effects and vascular compliance of patients with chronic cor pulmonale complicated with PH, significantly reduce the pulmonary artery pressure of patients, and significantly improve the cardiac function of patients.