目的 探究波生坦联合伐地那非治疗先天性心脏病术后肺动脉高压的临床疗效及对血管内皮功能的影响。方法 2011年11月-2015年12月郑州市第七人民医院重症医学科收治的80例先天性心脏病术后肺动脉高压患者为研究对象。根据术后拔除气管插管顺序随机分为观察组（40例）和对照组（40例）。两组患者均给予持续吸氧、利尿等常规治疗。在此基础上，对照组口服盐酸伐地那非片；观察组在对照组的基础上加服波生坦，两组均治疗6个月。比较两组患者临床有效率、临床症状缓解情况、心脏功能的情况。结果 治疗后对照组的临床总有效率为80.0%，观察组的临床总有效率为90.0%，观察组的临床总有效率显著高于对照组，差异有统计学意义（P<0.05）。与治疗前比较，治疗后两组患者的肺动脉收缩压（sPAP）、肺动脉平均压（mPAP）均大幅下降（P<0.05），肺循环血流量/体循环血流量明显升高（P<0.05）；且观察组的变化较对照组更为显著，差异有统计学意义（P<0.05）。与治疗前比较，治疗后两组患者的呼吸困难评分（Borg）、心脏功能分级（NYHAFC）评分均大幅下降（P<0.05），且观察组上述指标评分显著低于对照组，差异有统计学意义（P<0.05）。治疗后，两组患者血管内皮生长因子（VEGF）水平均治疗前大幅下降（P<0.05），且观察组下降幅度较对照组更为明显，差异有统计学意义（P<0.05）。两组在不良反应方面比较，差异无统计学意义。结论 波生坦联合伐地那非治疗先天性心脏病术后肺动脉高压的临床效果显著，可显著改善患者呼吸困难等临床症状，改善心脏功能，值得临床推广。

Objective To explore the clinical effect of bosentan combined with vardenafil on postoperative pulmonary hypertension associated with congenital heart and its influence on function of vascular endothelium. Methods 80 congenital heart disease patients with postoperative pulmonary hypertension, who were treated in our hospital from November, 2011 to December, 2015 were enrolled in the present study. They were randomly divided into observation group and control group, with each group of 40 cases. Both group received conventional therapy of oxygen and dieresis. The clinical effect, clinical symptom improvement, cardiac function were compared between the two groups. Results The clinical effect of control group was 80.0% (32/40), which was significantly lower than that of observation group (90.0%, P<0.05). The sPAP, mPAP in both group were significantly decreased, and the Qp/Qs level was obviously increased (P<0.05); Borg score and NYHAFC score as well as the level of VEGF were largely decreased, and those of observation group were significantly lower than control group (P<0.05). In the terms of adverse reactions, there was no statistical difference between the two groups. Conclusion Bosentan combined with vardenafil was effective on postoperative pulmonary hypertension associated with congenital heart, which can significantly improve the clinical symptoms of patients with dyspnea, improve the cardiac function, worthy of clinical promotion.