AU - Hoeper, M.M. AU - Spiekerkoetter, E. AU - Westerkamp, V. AU - Gatzke, R. AU - Fabelh . TI -静脉注射治疗失败的iloprost aerosolised iloprost肺动脉高血压援助- 10.1183 / 09031936.02.02462001 DP - 2002 8月01 TA -欧洲呼吸杂志》第六PG - 339 - 343 - 20 //www.qdcxjkg.com/content/20/2/339.short的IP - 2 4099 - 4100——//www.qdcxjkg.com/content/20/2/339.full——欧元Respir J2002 8月1日;20 AB -雾化伊洛前列素(一种前列环素类似物)治疗肺动脉高压(PAH)患者有有益效果。目前尚不清楚在雾化伊洛前列素治疗中病情恶化的患者是否能从持续静脉注射伊洛前列素中获益。目前的作者报告了16例严重PAH患者，在伊洛前列素雾化治疗的原发或继发失败后继续接受伊洛前列素静脉注射。疗效的决定因素是生存期、纽约心脏协会(NYHA)分级和6分钟步行试验中的步行距离。在93例经伊洛前列素雾化治疗的PAH患者中，16例因临床恶化而需改用静脉注射伊洛前列素。这些患者有严重的右心衰，心脏指数为1.6±0.2 L·min - 1·m - 2，混合静脉血氧饱和度为52±6%。其中5名患者没有好转，最终死亡。 Three patients had further deterioration in NYHA class and exercise capacity; two of them underwent lung transplantation; the third patient is still alive. Eight patients showed marked clinical improvement; one underwent lung transplantation and the others are currently alive and stable. In the latter group of patients, the walking distance in the 6‐min walk test increased from 205±94 to 329±59 m. It was not possible to identify clinical or haemodynamic factors that would predict whether switching from inhaled to intravenous iloprost would have a beneficial effect. In patients with pulmonary arterial hypertension who deteriorated while being treated with aerosolised iloprost, switching to continuous intravenous iloprost caused substantial improvement in exercise capacity in eight of 16 patients but could not prevent progression of pulmonary hypertension in the remaining eight patients. Since it was impossible to predict the individual effects of this approach, intravenous prostaglandin treatment should be considered in pulmonary arterial hypertension patients who deteriorate while receiving iloprost aerosol.