目的 探討安立生坦聯(lián)合伊洛前列素治療肺動(dòng)脈高壓的臨床療效。方法 選擇2020年5月—2022年5月在聊城市第二人民醫(yī)院治療的98例肺動(dòng)脈高壓患者，隨機(jī)分為對(duì)照組（49例）和治療組（49例）。對(duì)照組患者給予吸入用伊洛前列素溶液，2.5 μg/次，6次/d。在對(duì)照組基礎(chǔ)上，治療組口服安立生坦片，5 mg/次，1次/d。兩組患者連續(xù)治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀改善時(shí)間，6 min步行距離試驗(yàn)（6MWD）、Borg指數(shù)和肺動(dòng)脈收縮壓（PASP）指標(biāo)，血清因子N末端B型利鈉肽原（NT-proBNP）、內(nèi)皮素-1（ET-1）、腫瘤壞死因子-α（TNF-α）和血管內(nèi)皮生長(zhǎng)因子（VEGF）水平，及不良反應(yīng)情況。結(jié)果 治療后，治療組臨床有效率為97.96%，明顯高于對(duì)照組（81.63%，P＜0.05）。治療后，治療組癥狀改善時(shí)間均明顯短于對(duì)照組（P＜0.05）。治療后，兩組6MWD明顯升高，而B(niǎo)org指數(shù)評(píng)分、PASP指標(biāo)明顯降低（P＜0.05），且治療組這些指標(biāo)明顯好于對(duì)照組（P＜0.05）。治療后，兩組血清因子NT-proBNP、ET-1、TNF-α、VEGF水平均明顯低于治療前（P＜0.05），且治療組明顯低于對(duì)照組（P＜0.05）。治療后，治療組不良反應(yīng)發(fā)生率為10.21%，對(duì)照組為12.24%，兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 安立生坦聯(lián)合伊洛前列素可顯著降低肺動(dòng)脈高壓，改善肺血流動(dòng)力狀態(tài)，使機(jī)體炎性反應(yīng)降低，且安全性高。

Objective To investigate the clinical effect of ambrisentan combined with iloprost in treatment of pulmonary hypertension. Methods Patient (98 cases) with pulmonary hypertension in the Second People's Hospital of Liaocheng from May 2020 to May 2022 were randomly divided into control (49 cases) and treatment (49 cases) group. Patient in the control group was administered with Iloprost Solution for inhalation, 2.5 μg/time, six times daily. Patient in the treatment group were po administered with Ambrisentan Tablets on the basis of the control group, 5 mg/time, once daily. Patient in two groups were treated for 7 d. After treatment, the clinical evaluation was evaluated, and the improvement time of symptom, 6MWD, Borg index and PASP index, the levels of serum factor NT-proBNP, ET-1, TNF-α, and VEGF, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.96%, which was significantly higher than that of the control group (81.63%, P < 0.05). After treatment, the improvement time of symptom in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, 6MWD was significantly increased, while Borg index score and PASP index were significantly decreased in two groups (P < 0.05), and these indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum levels of NT-proBNP, ET-1, TNF-α, and VEGF in two groups were significantly lower than those before treatment (P < 0.05), and these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the incidence of adverse conditions was 10.21% in the treatment group and 12.24% in the control group, and there was no statistical significance between the two groups. Conclusion The combination of iloprost and ambrisentan can significantly reduce pulmonary hypertension, improve pulmonary hemodynamics, reduce systemic inflammatory response and have high safety.

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