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目的:观察静脉间歇应用硝酸甘油对体循环的影响和改善不同程度肺动脉高压(PH)的疗效,探讨静脉间歇应用硝酸甘油治疗先天性心脏病合并PH的应用价值。方法:选取32例左向右分流型先天性心脏病(CHD)合并PH患儿,静脉间歇应用硝酸甘油0.5~10μg·kg-1·min-1,每日递增。观察不同剂量硝酸甘油对体循环压及肺动脉压的作用、疗效及不良影响。结果:研究观察持续用药耐药性强,对体循环影响大,可见血压下降。采用间歇用药,逐日递增对体循环影响小。对轻、中、重度PH患者均疗效明显;对已发生艾森曼格氏综合征的患者疗效不佳。结论:静脉间歇应用硝酸甘油对体循环影响不大,可有效地降低左向右分流心排出量,减缓PH的形成,便于临床应用。
OBJECTIVE: To observe the effect of intravenous intermittent nitroglycerin on systemic circulation and to improve pulmonary hypertension (PH), and to explore the value of intravenous intermittent nitroglycerin in the treatment of congenital heart disease complicated with PH. Methods: Thirty-two cases of CHD with PH and intermittent intravenous injection of nitroglycerin 0.5 ~ 10μg · kg-1 · min-1 were enrolled in daily routine. To observe the effects of different doses of nitroglycerin on systemic pressure and pulmonary arterial pressure, efficacy and adverse effects. Results: The study observed continuous drug resistance is strong, the impact on the systemic circulation, showing decreased blood pressure. Intermittent drug use, increasing daily impact on the systemic circulation is small. Efficacy of light, moderate and severe PH patients are obvious; for patients who have had Eisenmenger’s syndrome is not effective. Conclusion: Intravenous intermittent application of nitroglycerin has little effect on systemic circulation, which can effectively reduce the left to right shunt cardiac output and slow down the formation of PH for clinical application.