Effect of combination therapy of ambrisentan and sildenafil on pulmonary arterial hypertension and its impact on pulmonary arterial pressure and exercise endurance
10.3760/cma.j.cn101721-20240626-00195
- VernacularTitle:安立生坦联合西地那非治疗肺动脉高压的效果及对肺动脉压力、运动耐力的影响
- Author:
Ya WANG
1
;
Qian WANG
1
Author Information
1. 四川省成都市第三人民医院心内科，成都 610000
- Publication Type:Journal Article
- Keywords:
Ambrisentan;
Sildenafil;
Pulmonary hypertension;
Pulmonary artery pressure;
Exercise tolerance
- From:
Clinical Medicine of China
2025;41(1):37-43
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of combination therapy of ambrisentan and sildenafil in the treatment of pulmonary arterial hypertension (PH) and its effects on pulmonary arterial pressure and exercise endurance.Methods:A retrospective analysis was conducted on the clinical data of 156 patients with PH who visited the Department of Cardiology at the Third People's Hospital of Chengdu from August 2021 to August 2023. According to the principle of 1∶1 baseline feature matching between groups, they were divided into an observation group and a control group, with 78 patients in each group. The control group was treated with sildenafil, while the observation group was treated with combination therapy of anlisentan and sildenafil. Compare the clinical efficacy and incidence of adverse reactions during treatment between two groups of patients. Compare the pulmonary artery pressure (mean pulmonary artery pressure (mPAP), pulmonary artery wedge pressure (PAWP), pulmonary vascular resistance (PVR), heart index), arterial blood gas indicators (oxygen partial pressure, partial pressure of carbon dioxide (PaCO 2), oxygen saturation), serum biochemical indicators (N-terminal pro brain natriuretic peptide (NT pro BNP), endothelin 1), and exercise tolerance between two groups of patients before and after one month of treatment. Strength (6-minute walking distance, 6MWD) level. The t-test was used for inter group comparison of metric data that conforms to normal distribution, the percentage was calculated for count data, and the chi square test is used for inter group comparison. Results:The total effective rate of the observation group (98.7%, 77/78) was significantly higher than that of the control group (91.0%, 71/78), and the difference was statistically significant ( χ2=4.74, P=0.029); There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). After 1 month of treatment, the mPAP ((46.01±7.23), (48.58±8.34) mmHg), PAWP((9.53±1.01), (10.14±1.17) mmHg), PVR((9.28±1.41), (10.04±1.33) Wood), PaCO 2((39.89±5.26), (43.35±4.73) mmHg), NT-pro BNP((427.78±85.05), (513.14±114.53) ng/L) and endothelin-1((55.10±8.37), (66.01±9.78) μg/L) in observation group and control group were significantly reduced than those before treatment ((62.21±10.63), (61.89±11.07) mmHg), (10.86±1.49), (11.19±1.50) mmHg), (12.02±1.57), (11.69±1.70) Wood), (55.99±6.10), (56.22±5.87) mmHg), (1 408.32±513.98), (1 400.89±524.14) ng/L), (89.03±9.79), (87.88±11.24) μg/L)), and the difference was statistically significant ( t values were 16.02, 12.11, 9.40, 6.95, 16.24, 9.62, 25.03, 21.45, 28.91, 24.55, 33.00, and 18.38, respectively; all P<0.001), and the indicators in observation group were lower than the control group, and the difference was statistically significant ( t values were 2.06, 3.49, 3.46, 4.32, 5.29, and 7.49, respectively; P values were 0.041, <0.001, 0.001, <0.001, <0.001, and <0.001, respectively). The cardiac index((2.98±0.57), (2.79±0.51) L/(min·m 2)), partial pressure of oxygen((78.87±8.48), (69.71±7.13) mmHg), oxygen saturation((84.33±8.84)%, (76.01±9.51)%) and 6MWD((448.01±32.88), (409.36±28.91) m) in observation group and control group were significantly enhanced compared with those before treatment ((2.51±0.46), (2.58±0.42) L/(min·m 2), (40.79±5.57), (41.01±5.49) mmHg), (60.26±7.45) %, (59.41±8.64)%), (190.76±24.54), (191.31±23.49) m) ( t values were 8.06, 3.99, 47.87, 40.17, 26.10, 16.16, 79.14, and 73.50, respectively; P<0.001), and the above indicators were higher in observation group, and the difference was statistically significant ( t values were 2.19, 7.30, 5.66, and 7.80, respectively; P values were 0.029, <0.001, <0.001, and <0.001, respectively). Conclusion:The combination therapy of ambrisentan and sildenafil shows significant efficacy in patients with PH, effectively reducing pulmonary artery pressure and serum biochemical indicators, improving arterial blood gas indicators, significantly enhancing patient exercise endurance, and possessing good safety.
