Abstract：Objective: To investigate the efficacy and safety of macitentan combined with tadalafil in the treatment of pulmonary arterial hypertension. Methods: 80 patients with pulmonary arterial hypertension were selected as the research subjects of this prospective study. The case collection time was from March 2021 to March 2022. All included cases were screened according to the inclusion and exclusion criteria. The 80 patients were divided into a control group and an experimental group of 40 patients each, and the grouping method was a simple randomized grouping method. The control group was treated with oral tadalafil tablets, and the observation group was treated with macitentan tablets on top of the control group. Both groups were treated for 12 consecutive weeks. The echocardiographic indexes such as pulmonary artery flat pressure (MPAP), mean systemic arterial pressure (MSAP), systemic circulation resistance (SVR) and pulmonary circulation resistance (PVR) were compared between the two groups before and after treatment, and the six-minute walk distance test (6MWD) and the Borg dyspnoea score were compared, and serum vascular endothelial factor-1 (ET) and C-reactive protein (CRP) levels were compared between the two groups of patients. The safety of the two groups of patients during treatment was compared. Results: MPAP, MSAP, SVR and PVR were lower in both the control and test groups at the end of treatment compared to the pre-treatment period, and the difference in MPAP, MSAP, SVR and PVR was more significant in the test group compared to the control group before and after treatment (P<0.05). After treatment, MPAP, MSAP, SVR, PVR in the control group and the test group were lower than those before treatment, and MPAP, MSAP, SVR, PVR in the test group were more significant than those before treatment (P<0.05). After treatment, Borg scores of the control group and the test group decreased compared with those before treatment, and Borg scores of the test group were more significant than those of the control group before and after treatment (P<0.05). After treatment, 6MWD of the control group and the test group increased compared with those before treatment, and 6MWD of the test group was more significant than those of the control group before and after treatment (P<0.05). After treatment, the levels of serum ET-1 and CRP in the control group and the test group were lower than those before treatment, and the levels of serum ET-1 and CRP in the test group were significantly lower than those in the control group (P<0.05). There were no adverse events in both groups during the treatment. Conclusion: Macitentan combined with tadalafil in the treatment of pulmonary hypertension can significantly reduce hemodynamic indexes, improve respiratory symptoms, reduce inflammatory response, and the treatment is safe.
2023, Vol. 29 
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