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| Effect of nitric oxide inhalation combined with sildenafil for treating neonates with pulmonary hypertension, and its influence on vascular endothelium and cytokines |
| 1. Affiliated Hospital of Qinghai University, Xining, Qinghai Province,810000; 2. Xining Maternal and Child Health Care Hospital of Qinghai Province |
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Abstract Objective: To investigate the effect of nitric oxide (NO) inhalation combined with sildenafil for treating neonates with pulmonary hypertension, and to study the influence of NO inhalation combined with sildenafil on vascular endothelium and cytokines of neonates. Methods: 68 neonates with pulmonary hypertension were randomly divided into the observation group and the control group (34 cases in each group). Neonates in the control group were treated by NO inhalation, and neonates in the observation group were treated by NO inhalation combined with sildenafil. The clinical efficacy, the values of oxygen partial pressure (PaO2) before and after treatment, carbon dioxide partial pressure (PaCO2), blood oxygen saturation (SaO2) and pulmonary systolic pressure (PASP), and the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), tumor necrosis factor-α(TNF-α), interleukin-8 (IL-8),ischemia-inducing factor (HIF-1α), endothelin-1 (ET-1) and NO of neonates were compared between the two groups. Results: The total effective rate of neonates in the observation group was 94.1%, which was significant higher than that (70.6%) of neonates in the control group (P<0.05). After treatment, the values of PaO2 before treatment (82.71±10.35mmHg) and SaO2 after treatment (96.57±3.36%) of neonates in the observation group were significant higher than those of neonates in the control group, but the values of PaCO2 (35.05±8.19mmHg) and PASP (25.39±6.34mmHg) of neonates in the observation group were significant lower (P<0.05). The levels of NT-proBNP (341.65±118.68 ng/ml), TNF-α (4.59±0.81 ng/ml), IL-8 (2.96±0.52 ng/ml), HIF-1α(304.51±45.29 pg/ml), and ET-1 (46.21±25.27pg/ml) of neonates in the observation group were significant lower than those of neonates in the control group, while level of NO (27.03±11.79μmol/L) of neonates in the observation group was significant higher (P<0.05). Conclusion: NO inhalation combined with sildenafil can significantly improve the vascular endothelial function of neonates with pulmonary hypertension, regulate the expression of cytokines such as inflammatory factors, and improve the clinical therapeutic effect of neonatal pulmonary hypertension.
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