威而鋼在海拔 5200 公尺不能降低AMS機率但會加重AMS症狀

High Alt Med Biol. 2011 Fall;12(3):207-14. doi: 10.1089/ham.2011.0007.
Sildenafil citrate (Viagra,威而鋼) 預防高海拔低氧性肺動脈高壓雙盲隨機對照研究
Sildenafil citrate for the prevention of high altitude hypoxic pulmonary hypertension: double blind, randomized, placebo-controlled trial.
PASP 肺動脈收縮壓 pulmonary arterial systolic pressure

Bates MG1, Thompson AA, Baillie JK, Sutherland AI, Irving JB, Hirani N, Webb DJ.  Author information
Abstract
這篇研究發表於 2011年秋天, 高海拔醫學雜誌
低氧性肺血管收縮是造成高海拔肺水腫 HAPE 的關鍵因素, 威而鋼有擴張肺血管的效果, 曾被認為可預防HAPE, 這篇研究是隨機雙盲對照實驗, 收錄 62位健康成人, 36名男性, 中位數年齡 21 歲(18-31歲), 於波利維亞的拉帕斯山谷, 海拔 3650 公尺, 在研究考察的行程,  經過四到五天高度適應, 於 90 分鐘內攀升至海拔 5200 公尺
實驗組 20 人服用每次 50mg 威而鋼, 每天三次, 使用心臟超音波測量海平面, 及抵達海拔 5200 公尺後六小時內, 三天, 一周, 肺動脈壓力. 
Exaggerated hypoxic pulmonary vasoconstriction is a key factor in the development of high altitude pulmonary edema (HAPE). Due to its effectiveness as a pulmonary vasodilator, sildenafil has been proposed as a prophylactic agent against HAPE. By conducting a parallel-group double blind, randomized, placebo-controlled trial, we investigated the effect of chronic sildenafil administration on pulmonary artery systolic pressure (PASP) and symptoms of acute mountain sickness (AMS) during acclimatization to high altitude. Sixty-two healthy lowland volunteers (36 male; median age 21 years, range 18 to 31) on the Apex 2 research expedition were flown to La Paz, Bolivia (3650 m), and after 4-5 days acclimatization ascended over 90 min to 5200 m. The treatment group (n=20) received 50 mg sildenafil citrate three times daily. PASP was recorded by echocardiography at sea level and within 6 h, 3 days, and 1 week at 5200 m. 

每天使用 LLS 評估 AMS. 實驗組與對照組在海拔 5200 公尺的肺動脈收縮壓 PASP 無差異, 海拔 5200 公尺第二天的AMS中位分數在實驗組較高, 但兩組AMS盛行率無差異, 威而鋼不會降低平地人在海拔 5200 公尺的肺動脈收縮壓 PASP, 研究結果不建議一般沒有罹患過HAPE的人預防性使用威而鋼於高海拔降低 PASP
AMS was assessed daily using the Lake Louise Consensus symptom score. On intention-to-treat analysis, there was no significant difference in PASP at 5200 m between sildenafil and placebo groups. Median AMS score on Day 2 at 5200 m was significantly higher in the sildenafil group (placebo 4.0, sildenafil 6.5; p=0.004) but there was no difference in prevalence of AMS between groups. Sildenafil administration did not affect PASP in healthy lowland subjects at 5200 m but AMS was significantly more severe on Day 2 at 5200 m with sildenafil. Our data do not support routine prophylactic use of sildenafil to reduce PASP at high altitude in healthy subjects with no history of HAPE. TRIALS REGISTRATION NUMBER: NCT00627965.

留言

這個網誌中的熱門文章

同時罹患高海拔腦水腫HACE及高海拔肺水腫HAPE之治療

高海拔疾病預防性藥物如何使用

帶狀泡疹