法舒地尔对慢性阻塞性肺疾病合并肺动脉高压患者血浆脑钠肽的影响

Influence of Fasudil on plasma brain natriuretic pepetide of patients with chronic obstructive pulmonary disease and pulmonary hypertension

目的探讨法舒地尔对慢性阻塞性肺疾病(COPD)合并肺动脉高压患者血浆脑钠肽(BNP)的影响。方法选择80例COPD合并肺动脉高压患者,随机分为对照组和法舒地尔组,每组40例,对照组给予抗炎、解痉、平喘、化痰、吸氧等常规治疗,法舒地尔组在常规治疗的基础上加用法舒地尔注射液;两组患者入院后测定血浆BNP、动脉血气、心脏彩超检查,14 d后复查,比较两组间治疗前、治疗后血浆BNP、肺动脉收缩压(PASP)、动脉血p H、Pa O2、Pa CO2、氧合指数(Pa O2/Fi O2)等相关数值的差异。结果治疗前两组患者血浆BNP、PASP、动脉血p H、Pa O2、Pa CO2、Pa O2/Fi O2等相关数值的差异均无统计学意义(P均>0.05);法舒地尔组患者治疗后血浆BNP(98±12)pg/ml、PASP(32.5±7.8)mm Hg、Pa CO2(45.3±10.6)mm Hg均明显低于对照组患者治疗后的(210±73)pg/ml、(45.2±9.7)mm Hg、(58.4±12.7)mm Hg(P均<0.05);而动脉血p H(7.40±0.15)、Pa O2(81.3±15.6)mm Hg、Pa O2/Fi O2(387.8±56.4)mm Hg均明显高于对照组患者治疗后的(7.36±0.09)、(72.7±14.3)mm Hg、(346.8±61.2)mm Hg(P均<0.05)。结论法舒地尔可以降低COPD合并肺动脉高压患者血浆BNP水平,可能与其降低肺动脉压力有关。

Objective To explore the influence of Fasudil on brain natriuretic peptide （BNP） in plasma of patients with chronic obstructive pulmonary disease （COPD） and pulmonary hypertension.Methods A total of 80 cases of patients with COPD and pulmonary hypertension were randomly divided into two groups：control group of 40 cases to whom the conventional treatments such as anti-infection,bmnchodilator,antiasthma,expectorant and oxygen therapy were administered; Fasudil group of 40 cases to whom Fasudil was administered intravenously besides the conventional treatments.Plasma BNP,arterial blood gas and echocardiography were assayed in both groups after the admission and 14 days after the admission for the comparison of plasma BNP,pulmonary artery systolic pressure（PASP）,arterial blood pH,PaO2,PaCO2 and oxygenation index （PaO2/FiO2） between the two groups before and after the treatment.Results There were no statistical difference between two groups in the plasma BNP,PASP,arterial blood pH value,PaO2,PaCO2 and PaO2/FiO2 （all P ＞ 0.05）.After the treatment,the plasma BNP （98 ± 12） pg/ml,PASP （32.5 ± 7.8）mmHg and PaCO2 （45.3 ± 10.6） mmHg of Fasudil group were significantly lower than those of the control group （210 ± 73） pg/ml,（45.2 ± 9.7） mmHg、（58.4 ± 12.7） mmHg,respectively （all P ＜ 0.05） while the arterial blood pH value （7.40 ± 0.15）,PaO2 （81.3 ± 15.6） mmHg and PaO2/FiO2 （387.8 ± 56.4） mmHg of Fasudil group were significantly higher than those of the control group（7.36 ±0.09）,（72.7 ± 14.3）mmHg,（346.8 ±61.2） mmHg,respectively （all P ＜ 0.05）.Conclusion Fasudil can reduce the BNP level in plasma of patients with COPD and pulmonary hypertension by reducing possibly pulmonary arterial pressure.