目的 探讨安立生坦联合伊洛前列素治疗肺动脉高压的临床疗效。方法 选择2020年5月—2022年5月在聊城市第二人民医院治疗的98例肺动脉高压患者，随机分为对照组（49例）和治疗组（49例）。对照组患者给予吸入用伊洛前列素溶液，2.5 μg/次，6次/d。在对照组基础上，治疗组口服安立生坦片，5 mg/次，1次/d。两组患者连续治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者症状改善时间，6 min步行距离试验（6MWD）、Borg指数和肺动脉收缩压（PASP）指标，血清因子N末端B型利钠肽原（NT-proBNP）、内皮素-1（ET-1）、肿瘤坏死因子-α（TNF-α）和血管内皮生长因子（VEGF）水平，及不良反应情况。结果 治疗后，治疗组临床有效率为97.96%，明显高于对照组（81.63%，P＜0.05）。治疗后，治疗组症状改善时间均明显短于对照组（P＜0.05）。治疗后，两组6MWD明显升高，而Borg指数评分、PASP指标明显降低（P＜0.05），且治疗组这些指标明显好于对照组（P＜0.05）。治疗后，两组血清因子NT-proBNP、ET-1、TNF-α、VEGF水平均明显低于治疗前（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，治疗组不良反应发生率为10.21%，对照组为12.24%，两组比较差异无统计学意义。结论 安立生坦联合伊洛前列素可显著降低肺动脉高压，改善肺血流动力状态，使机体炎性反应降低，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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